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.
Periodontitis is a dysbiosis-driven inflammatory disease in which a pathogenic subgingival biofilm disrupts the host–microbe equilibrium and promotes progressive loss of tooth-supporting tissues. While periodontal destruction has traditionally been explained mainly through the host immune response, increasing experimental and clinical evidence suggests that epithelial–mesenchymal transition (EMT)-like changes in the gingival epithelium may contribute to barrier failure and tissue remodeling during disease progression. EMT is characterized by reduced epithelial adhesion and polarity, alongside a shift toward a mesenchymal-like phenotype with enhanced motility and impaired epithelial barrier function. This narrative review focuses
... Show MoreThyroid disease is a common disease affecting millions worldwide. Early diagnosis and treatment of thyroid disease can help prevent more serious complications and improve long-term health outcomes. However, thyroid disease diagnosis can be challenging due to its variable symptoms and limited diagnostic tests. By processing enormous amounts of data and seeing trends that may not be immediately evident to human doctors, Machine Learning (ML) algorithms may be capable of increasing the accuracy with which thyroid disease is diagnosed. This study seeks to discover the most recent ML-based and data-driven developments and strategies for diagnosing thyroid disease while considering the challenges associated with imbalanced data in thyroid dise
... Show MoreErosion and deposition are natural phenomena in many estuaries that can cause morphological changes, leading to navigation and offshore structure problems. Many previous studies have focused on investigating the morphological changes of estuaries depending on different parameters and their combined effects with erosion and deposition processes, such as maximum flow amplitude, waves, currents, tidal flow, storms, rising sea elevation, maximum turbidity, salinity, and bed roughness height as input parameters. These studies are based on field measurements and numerical simulations by using topographic surveys, soil samples, satellite images, geological data, and bathymetric maps with the aid of ArcGIS. Some of these studies examine the
... Show MoreExploring the antibacterial potential of neem oil (Azadirachta indica) in combination with gentamicin (GEN) against pathogenic molds, especially Pseudomonas aeruginosa, has drawn concern due to the quest for natural treatment options against incurable diseases. Prospective research directions include looking for natural cures for many of the currently incurable diseases available now. microbial identification system, were used to identify the isolates. The research utilized a range of methods, such as the diffusion agar well (AWD) assays, TEM (transmission electron microscopy) analysis, minimum inhibitory concentration (MIC) assays, and real-time PCR (RT-qPCR) to analyze bacterial expression and the antibacterial action of neem oil (Azadira
... Show MoreThe research aimed to identify the level of job security, the level of sports institutional performance, and the relationship, contribution and impact of job security to sports institutional performance from the point of view of workers in the Iraqi Ministry of Youth and Sports. The descriptive approach was adopted in the manner of correlational relationships on a sample of (400) individuals who were randomly selected by (33.333%) of the employees working in the institutions at the headquarters of the Ministry of Youth and Sports, amounting to a total of (2293) individuals for the sports season (2022-2023), and they are naturally distributed among (13) main institutions in the formations of the headquarters of this ministry, and after adopt
... Show MoreObjectives: The aim of the study is to evaluate the information of caregivers concerned emergency care for the elderly and to identify the relationship between caregiver information and their educational level, years of service and training courses. Methodology: A quasi-experimental study was conducted in the Geriatric Care Home in Baghdad City (the governmental and private geriatric care home ) for the period from October, 14th , 2018 to March, 20th , 2019 to find the effectiveness of the instructional program on caregivers knowledge about emergency care for the elderly.. A purposive sample (non-probability) was consisting of (30) males and females caregivers, the sample was selected from geriatric care home in Baghdad city .To implemen
... Show MoreConcentrations 25, 50 and 100 mg of nano-capsules linolenic acid and non-capsulated fatty acid for 1kg of Milk was used for yogurt manufacture. The results showed no significant differences in the ratio of titration acidity and pH values between all processed treatments at the beginning and during of period storage. The treatments was added to it coated omega-3 by nano method were the least exposed to the oxidation process from the non-capsules omega-3, And for shield of The poly lactic acid had a significant role in the protection of alpha-linolenic acid against lipolysis by the formation of a protective layer to protect the acid from the activity of lipases enzymes, and the addition of fatty acid linolenic to milk was determined the gr
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