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.
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
... Show MoreAbstract 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
The study aimed at identifying the strategic gaps in the actual reality of the management of public organizations investigated to determine the strategy used based on the study model. The study relied on the variable of the general organization strategy in its dimensions (the general organization strategy, the organization's political strategy and the defense strategy of the organization) The sample of the study was (General Directorate of Traffic, Civil Status Directorate and Civil Defense Directorate), formations affiliated to the Ministry of the Interior, for the importance of the activity carried out by these public organizations by providing them In order to translate the answers into a quantitative expression in the analysi
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It is essential to provide health care directly or indirectly based on laboratory tests in order of diagnosing diseases. There is an urgent need for the results of such tests to be accurate and reliable. Therefore, the International Organization for Standardization has prepared special standards for medical laboratories to prove their efficiency, presented in standards 15189: 2012. The aim of the research is to determine the possibility of the Al-alwiya Women's Hospital in meeting the requirements of the standards 15189: 2012, which includes administrative requirements consisting of fifteen items and technical requirements consisting of ten items. The research is important because laboratories shou
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The prevalence of gastrointestinal symptoms of COVID-19 is variable with different types of presentations. Some of them many present with manifestations mimicking surgical emergencies. Yet, the pathophysiology of acute abdomen in the context of COVID-19 remains unclear. We present a case of a previously healthy child who presented with acute appendicitis with multisystemic inflammatory syndrome. We also highlight the necessity of considering the gastrointestinal symptoms of COVID-19 infection in pediatric patients in order to avoid misdiagnosis and further complications. |
The spread of novel coronavirus disease (COVID-19) has resulted in chaos around the globe. The infected cases are still increasing, with many countries still showing a trend of growing daily cases. To forecast the trend of active cases, a mathematical model, namely the SIR model was used, to visualize the spread of COVID-19. For this article, the forecast of the spread of the virus in Malaysia has been made, assuming that all Malaysian will eventually be susceptible. With no vaccine and antiviral drug currently developed, the visualization of how the peak of infection (namely flattening the curve) can be reduced to minimize the effect of COVID-19 disease. For Malaysians, let’s ensure to follow the rules and obey the SOP to lower the
This article is an endeavour to highlight the relationship between social media and language evolution. It reviews the current theoretical efforts on communication and language change. The descriptive design, which is theoretically based on technological determision, is used. The assumption behind this review is that the social media plays a significant role in language evolution. Moreover, different platforms of social media are characterized by being the easiest and fastest means of communication. It concludes that the current theoretical efforts have paid much attention to the relationship between social media and language evolution. Such efforts have highlighted the fact that social media platforms are awash with a lot of acronyms, cybe
... Show MoreRecently a large number of extensive studies have amassed that describe the removal of dyes from water and wastewater using natural adsorbents and modified materials. Methyl orange dye is found in wastewater streams from various industries that include textiles, plastics, printing and paper among other sources. This article reviews methyl orange adsorption onto natural and modified materials. Despite many techniques available, adsorption stands out for efficient water and wastewater treatment for its ease of operation, flexibility and large-scale removal of colorants. It also has a significant potential for regeneration recovery and recycling of adsorbents in comparison to other water treatment methods. The adsorbents described herein were
... Show MoreSickle cell disease (SCD) is a hereditary ailment that can cause severe pain and suffering to people who are affected. However, with continued investment in research and treatment options, we can make progress towards improving the lives of those with SCD. Over 40% of patients experience painful vaso-occlusive crises (VOCs), so we must work towards finding solutions and providing support for those living with this condition, These episodes, a hallmark of SCD, significantly contribute to morbidity, mortality, and a diminished quality of life, while also incurring substantial healthcare costs. Chronic pain particularly affects older adolescents and adults with SCD, with over half reporting daily discomfort. Opioid-based analgesics, though sti
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