An anal fissure which does not heal with conservative measures as sits baths and laxatives is a chronic anal fissure. Physiologically, it is the high resting tone of the internal anal sphincter that chiefly interferes with the healing process of these fissures. Until now, the gold standard treatment modality is surgery, either digital anal dilatation or lateral sphincterotomy. However, concerns have been raised about the incidence of faecal incontinence after surgery. Therefore, pharmacological means to treat chronic anal fissures have been explored. A Medline and pub med database search from 1986-2012 was conducted to perform a literature search for articles relating to the non-surgical treatment of chronic anal fissure. Pharmacological sphincterotomy using Glyceryl trinitrate , Isosorbide dinitrate or calcium channel blockers are exciting alternative treatment , that relaxes the anal sphincter and, therefore, promote healing, the drawback of such medications are headache and poor compliance. With the introduction of Botulinum toxin as mean of chemical sphincterotom, topical injection of Botulinum toxin reduces the anal hypertonia which lasts for few months, allows the fissure to heal, thus eliminating the need for surgery without incidence of incontinence. Cure rates are over 60%, and the procedure can be repeated safely. Therefore, Botulinum toxin is a reasonable first-line management of chronic anal fissure and the relapses can be managed by surgery Keywords: Non-surgical treatment of anal fissure, fissure in ano, sphicterotomy,botulinum toxin in anal fissures, glyceryl trinitrate. Chemical sphincteratomy, pharmacological sphincteratomy.
Background: Rheumatoid arthritis (RA) is a chronic and systemic autoimmune disease that is characterized by severe synovial inflammation, cartilage erosion, bone loss, and generalized vasculopathy. Although the immunologic mechanism of RA is still unclear, it is now thought to be a primarily Th17-driven disease. Along with other factors, IL-23 stimulates the expansion of Th17 cells from naive CD4+ T cells.
Objective: The objective of this study is to assess the circulating levels of interleukin (IL)-23 in rheumatoid arthritis (RA) and determine the correlation between plasma/serum IL-23 levels and disease activity. So, we performed a systematic review with meta-analysis comparing
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In this review, numerous analytical methods to distinguish pigments in tattoo, paint, and ink items are discussed. The selection of a method was dependent upon the purpose, e.g., quantification or identification of pigments. The introductory part of this review focuses on describing the importance of setting up a pigment-associated safety profile. The formation of different degradation chemical substances as well as impurity trends can be indicated through the chemical investigation of pigments in tattoo products. It is noteworthy that pigment recognition in tattoo inks can work as a preliminary method to identify the pigments in a patient's tattoo before being removed by laser therapy. Contrary to the stud
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In this review, numerous analytical methods to distinguish pigments in tattoo, paint, and ink items are discussed. The selection of a method was dependent upon the purpose, e.g., quantification or identification of pigments. The introductory part of this review focuses on describing the importance of setting up a pigment-associated safety profile. The formation of different degradation chemical substances as well as impurity trends can be indicated through the chemical investigation of pigments in tattoo products. It is noteworthy that pigment recognition in tattoo inks can work as a preliminary method to identify the pigments in a patient's tattoo before being removed by laser therapy. Contrary to the stud
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Background: Salivary tumors are uncommon, being of low incidence worldwide. This study aimed to assess cases collected in this series of salivary gland tumors in regard to histopathological typing, in relation to age, site and gender. Materials and methods: This is a retrospective study; cases were collected from public and private laboratories. A total number of 171 cases were collected. The slides were reviewed and reclassified for histopathological typing according to WHO classification 2005. Results: Benign tumors were more common than malignant tumors. The most common histological type was benign mixed tumor, followed by Warthin’s tumor. The most common malignant tumor was adenoid cystic carcinoma. One hundred twenty three cases ou
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Sensibly highlighting the hidden structures of many real-world networks has attracted growing interest and triggered a vast array of techniques on what is called nowadays community detection (CD) problem. Non-deterministic metaheuristics are proved to competitively transcending the limits of the counterpart deterministic heuristics in solving community detection problem. Despite the increasing interest, most of the existing metaheuristic based community detection (MCD) algorithms reflect one traditional language. Generally, they tend to explicitly project some features of real communities into different definitions of single or multi-objective optimization functions. The design of other operators, however, remains canonical lacking any inte
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Abstract A description study was carried through out the present study aimed to assess health education provided by nurses to patient with gall stone "obstructive jaundice". The study was conducted at 4 teaching hospital, Baghdad teaching hospital, Al-Karama teaching hospital, Al-Yarmook teaching hospital, Al-Kendy teaching hospital where choloecystectomy was performed, in the period from first of June 2004 to end of July 2004. Data were collected through the use of questionnaire an interview from which was developed for the purpose of the present study. A non-probability (purposive) sample which was consist
Abstract The concept of quantum transition is based on the completion of a succession of time dependent (TD) perturbation theories in Quantum mechanics (QM). The kinetics of "quantum" transition, which are dictated by the coupled motions of a lightweight electrons and very massive nuclei, are inherent by nature in chemical and molecular physics, and the sequence of TD perturbation theory become unique. The first way involved adding an additional assumption into molecule quantum theory in the shape of the Franck-Condon rule, which use the isothermal approach. The author developed the second strategy, which involved injecting chaos to dampen the unique dynamically of the bonding movement of electrons and nuclei in the intermediary state of
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