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.
Seven species of semi venomous Opisthoglypha snakes (Reptilia, Ophidia) of Iraq are listed with important characteristics in morphology due to geographical and individual variation of species, as well, the confusion in the scales count of Telescopus tessellatus martini (Schmidt, 1939) of Iraq are discussed.
حضيت القيادة باهتمام كبير من قبل الباحثين ودورها الإيجابي في التأثير على الموظفين ونجاح المنظمات، في الآونة الأخير بدأت الدراسات تركز على الجانب المظلم للقيادة وتأثيرها على التابعين وبيئة العمل، وقد تم تحديد القيادة السامة بأنها أخطر الأساليب القيادية التي تتسبب بتكاليف مادية ومعنوية على المنظمات بمختلف جوانبها، ان القيادة السامة تأثر على دوافع المرؤوسين وقدرتهم على انجاز المهام، ورغبتهم في الاستمرار في
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Schiff bases (SBs) represent multipurpose ligands that can be prepared from the concentration of prime amines with carbonyl clusters. Creation of SB transition metal compounds via as ligands has opportunity of attaining coordination complexes of abnormal arrangement and stability. These transition metal compounds have extraordinary attention as a consequence of their dynamic portion in metalloenzymes and as biomimetic prototypical complexes as a result of their proximity to usual enzymes and proteins. These complexes are imperative in medicinal disciplines owing to their widespread range of biological actions. They mostly exhibit organic actions involving antifungal, antibacterial, antitumor, antidiabetic, herbicidal, antiproliferative, ant
... Show MoreSeven species of semi venomous Opisthoglypha snakes (Reptilia, Ophidia) of Iraq are listed with important characteristics in morphology due to geographical and individual variation of species, as well, the confusion in the scales count of Telescopus tessellatus martini (Schmidt, 1939) of Iraq are discussed.
Schiff bases (SBs) represent multipurpose ligands that can be prepared from the concentration of prime amines with carbonyl clusters. Creation of SB transition metal compounds via as ligands has opportunity of attaining coordination complexes of abnormal arrangement and stability. These transition metal compounds have extraordinary attention as a consequence of their dynamic portion in metalloenzymes and as biomimetic prototypical complexes as a result of their proximity to usual enzymes and proteins. These complexes are imperative in medicinal disciplines owing to their widespread range of biological actions. They mostly exhibit organic actions involving antifungal, antibacterial, antitumor, antidiabetic, herbicidal, antiproliferative, ant
... Show MoreThis review discusses the gingival biotypes, their characteristics, analysis based on the measurement of the dentopapillary complex. Also discuss their response to inflammation, surgery, and ridge healing after tooth extraction, their influence in the behavior of the peri-implant tissue
For the duration of the last few many years many improvement in computer technology, software program programming and application production had been followed with the aid of diverse engineering disciplines. Those trends are on the whole focusing on synthetic intelligence strategies. Therefore, a number of definitions are supplied, which recognition at the concept of artificial intelligence from exclusive viewpoints. This paper shows current applications of artificial intelligence (AI) that facilitate cost management in civil engineering tasks. An evaluation of the artificial intelligence in its precise partial branches is supplied. These branches or strategies contributed to the creation of a sizable group of fashions s
... Show MoreThis paper aims to make a historical review of jet grouting techniques and encountered problems at different sites in several countries. This review is a good guide to understanding the performance and limitations of improved soils or lands. The basic concept of jet grouting technology is to use cement as a binder to accelerate the hardening process of an admixture of material grout and soil. The different case history was conducted in both sand soil and clay soil in the horizontal and vertical direction. Other papers on field construction showed that the grout can be gelled within 5-10 minutes. Due to different cases and studies, these will help improve soil by supporting the foundation load with a minimal settlement.
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Review of multidrug sensitivity and resistance in enterococcus