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.
Summary
I wanted to address this topic because of creedal purposes importance,and its r le in regulating lives of individuals and society, and to talk about purposes of Almighty's saying:{It is easy for me},to simplify its meanings for general educated person to obtain the believe of the Creator’s power and his oneness.
Therefore,this research came,whichincludes:an introduction and topics, first :concept of creedal objectives and their divisions,second: creedal purposes in Almighty’s saying:{It is easy for me},and conclusion:in where most important results were included:
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Throughout Agriculture has mostly relied on the use of natural fertilizers throughout human history, which are compounds that increase the nitrogen levels in the soil. Modern agriculture was made possible by the introduction of synthetic fertilizers at the end of the 19th centuryproduction of agriculture. Their application enhanced crop yields and sparked an agricultural revolution unlike anything the world had ever seen.In the near future, synthetic fertilizers are anticipated to continue to have a significant impa ct on human life, both positively and negatively. They are frequently utilized for producing all t ypes of crops and are essential to plant growth. The significance of synthetic fertilizers is their ability to provide the soil w
... Show MoreThe aims of the lecture should be clearly defmed. These will help to define the teaching methods and the structure. If, for example, the purpose of the lecture is to introduce new knowledge and concepts, then a classic lecture structure might be most appropriate. On the other hand, if the purpose is to make the students aware of different approaches to a particular clinical problem, a problem oriented design in which alternative approaches are presented and discussed might be a more appropriate fonnat.
Lectures are still a common teaching methOd in both undergraduate and postgraduak medical education. Properly done, the lectwe is a creative and personal work by the teachll:l modeled upon his intellectual scaffolding. Few other fonns o
Aim: The Aim of the study is to compare between Er,Cr:YSGG 2780 nm laser and carbide fissure bur in root-end resection regarding the morphological variations, temperature changes and the duration of resection process.
Settings and Design: 5 W, 25 Hz, 50% water, 80% air,25.47 J/cm2 .
Material and method: twenty-one extracted single rooted teeth endodontically were treated, twenty teeth were obturated and divided into two groups according to method of resection. Group 1 root-end resected using cross cut carbide bur while group 2 root-end resected using laser with MGG6 sapphire tip of 600 μm diameter. Temperature on external root surface and duration of resection were recor
... Show MoreMany water supplies are now contaminated by anthropogenic sources such as domestic and agricultural waste, as well as manufacturing activities, the public's concern about the environmental effects of wastewater contamination has grown. Several traditional wastewater treatment methods, such as chemical coagulation, adsorption, and activated sludge, have been used to eliminate pollution; however, there are several drawbacks, most notably high operating costs, because of its low operating and repair costs, the usage of aerobic waste water treatment as a reductive medium is gaining popularity. Furthermore, it is simple to produce and has a high efficacy and potential to degrade pollu
... Show MoreAn observational study to discover the common conditions affecting the lumbosacral region that may affect lumbosacral position and tension. All the patients, underwent MRI exaamination (magnetic resonance imaging) in the supine position, were examined by the same consultant radiologist. The article was revised by the institutional ethical approval committee. The position of the nerve roots was observed, and the number of nerve roots was calculated anterior to a line passing between the mid-transvers process of L3(third lumbar vertebra). The number of nerve roots ahead of this line was calculated by the radiologist at the level of the right intervertebral foramen and at the left one. This procedure was applied to the normal group, an
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China occupies an area of 906 million square km. and lies east Asia. Its population approximately 1,388 people, according to census 2010. China was a global great power for centuries , then shrank its jurisdiction and occupied by European countries and Japan in the 19th century. It regained its strength and independence under the leadership and rule of the Chinese Communist Party since 1949. In the 21st century , the Chinese positions has risen universally due to its achievements in the economic and trade affairs . Nowadays, China became a largest exporting state in the world and a second economic power after USA.
Due to its safety, low cost, real-time nature, and widespread availability, ultrasound has been employed as a diagnostic technique for numerous intraocular disorders. Unfortunately, speckle artifact that depends on the tissue is seen in ultrasound imaging. In this study, we present a technique for lowering speckle noise and enhancing ultrasound images to enhance human diagnostic performance. This technique combines the undecimated wavelet transform (UDWT) with a wavelet coefficient mapping function, which was utilized to improve the contrast of the denoised images acquired from the first component after the noise was removed using the UDWT. This technique can be used to enhance the visual quality of medical photographs as well as to enha
... Show MoreThis research deals with process of artistic conception of nature's images between becoming and buration, as an attempt to transfer the philosophical concepts to art via it's structural applications in forming the picture, due to the importance of these concepts which might be engaged with the vision of the artist in his own and subjective contention with the nature. The research consists of four chapters, first one included the problem of the research, importance, need to the research and the aim of the research represented by process of artistic conception of nature's images between becoming and buration. Also included the limits of research and most important terms. Second chapter included theoretical frame that consists of thre
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