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.
That corruption with all its forms, has prevailed over the whole world, but with different degrees relaying on the one who leads these countries of rulers, followers and officials who have been deemed the main reason for that corruption, but if these rulers were righteous, These countries would have blessed and elevated and were corrupt unjust tyrants who were the disaster that befell the chiefs of those countries with ruin, misery, and backwardness. This is what we sought to prove and clarify by considering the verses of the Holy Qur’an in respect with this topic. The research includes an introduction, two topics, and a conclusion.
 
... Show MoreEdward Albee (1928-2016) is an American dramatist who is notorious for his controversial works. Albee's plays generate a crisis of a restraint situation and a point of no return where characters trespass the limits and get caught up in a tragic cycle. The Goat or Who is Sylvia? )2000) is one of his controversial pieces, addressing (human-animal relations). This theatrical masterpiece unleashes man's wildest desires and ravaging behavior. Bestiality is a criminal offense placed in the domain of mental disorders attributed to the lack of emotional support, anxiety, depression, and psychological problems. It is also a serious moral infraction of communities' socio-religious traditions. In this play, Martin’s bestiality lead
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Abstractin adult typical atrioventricular nodal reentrant tachycardia (AVNRT) consider most common paroxysmalsupraventricular tachycardia. Dual pathway idea still accepted and used widely and commonly. According tothe guide line, ablations of slow pathway still the first treatment with good success rate.Identify the electrophysiological difference of atrioventricular nodal pathways pre and post ablation.Electrophysiological study was done to 54 patients with only typical type AVNRTs; they were 40 (74%)females and 14 (26%) males. Divided into two groups G1 with 38 patients (70.4%) having one pathway andG2 with 16 patients (29.6%) with multiple pathway. After induction we study the clinical andelectrophysiological feature of tachycardia and s
... Show MoreRecent studies have revealed some conflicting results about the health effects of caffeine. These studies are inconsistent in terms of design and population and source of consumed caffeine. In the current study, we aimed to evaluate the possible health effects of dietary caffeine intake among overweight and obese individuals.
In this cross-sectional study, 488 apparently healthy individuals with overweight and obesity were participated. Dietary intake was assessed by a Food Frequency Questionnaire (FFQ) and
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The objectives of this study were to review the literature covering the perceptions about influenza vaccines in the Middle East and to determine factors influencing the acceptance of vaccination using Health Belief Model (HBM).
A comprehensive literature search was performed utilizing PubMed and Google Scholar databases. Three keywords were used: Influenza vaccine, perceptions and Middle East. Empirical studies that dealt with people/healthcare worker (HCW) perceptio
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The objectives of this study were to review the literature covering the perceptions about influenza vaccines in the Middle East and to determine factors influencing the acceptance of vaccination using Health Belief Model (HBM).
A comprehensive literature search was performed utilizing PubMed and Google Scholar databases. Three keywords were used: Influenza vaccine, perceptions and Middle East. Empirical studies that dealt with people/healthcare worker (HCW) perceptio
(8)
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Dealing with this study to find a link principle in the construction of the system and disorder to the promise of the principles and concepts of intellectual and philosophical form and content in the act of interior design of the halls education in the Ministry of Labor and Social Affairs , which leads to a reaction design objective and functionally and to increase the strength of the effect on users of the coaches and trainers . As it informs the side cognitive and developmental study of the design of the interior spaces . So it was the goal of research in the detection of the nature of the system and disorder with Focus indicators and the type of regulations and privacy and what constitutes the framework of knowledge in order to explai
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Obesity is disorder in a foremost nutritional health it’s developed with countries developing. Also is known as increasingin fat accumulation that lead toproblem in health, besidesmay coin one of the reasons lead toloss of life,the obesity not effect on adults just but effect onoffspringand juveniles. In some ofinhabitants the incidence of obesity is superior in female than in male; on the other hand, the variation degree of the between the genderdifferby country.Obesity is generally measured by body mass index and waist circumference, Obesity are classified according to body mass index into:Pre obesity sort 1 : (25 - 29.9) kg/m2, Obesity sort 2 : (30 - 34.9 kg/m2) and extreme obesity sort 3: (40 kg/m2) or greater. Obesity is described by
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