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.
المواقف افي الدول العربية قراءة تحليلية في مواقف لدولية من التغيير (الولايات المتحدة - الاتحاد الاوروبي - روسيا)
The influence of process speed (PS) and tillage depth (TD) , on growth of corn (Zea mays L) yield, for Maha cultivar, were tested at two ranges of PS of 2.483 and 4.011 km.hr-1, and three ranges of TD of 15,20 and 25cm. The experiments were conducted in a factorial experiment under complete randomized design with three replications. The results showed that the PS of 2.483 km.hr-1 was significantly better than the PS of 4.011km.hr-1 in all studied conditions. The , slippage ratio (SR) and the machine efficiency (ME), the physical soil characteristics represented by the soil density and porosity (SBD and TSP), and the plant characteristics represented the roots dry weight, PVI and the crop productivity (CP), except adjective of the fu
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The corona virus epidemic outbreak has urged an extreme worldwide effort for re‐purposing obtainable approved medications for its treatment. In this review, we're focusing on the chemicals properties andpharmacologicaleffectiveness of medicationsofsmallmolecule that are presently being evaluated in clinical trials for the management of corona virus (COVID‐19). The current review sheds light on a number of drugs that have been diagnosed to treat COVID‐19 and their biological effects.
Nearly, in the middle of 1970s the split-brain theory became the only theory that explains human creativity used in all fine art and art education schools. In fact, this theory- which appeared for first time in the middle of 1940s – faced many radical changes including its concepts and structures, and these changes affected both teaching art and art criticism. To update people awareness within art field of study, this paper reviews the split-brain theory and its relationship with teaching art from its appearance to its decay in 2013 and after.
This systematic review aimed to analyse available evidence to answer two focused questions about the efficacy of erythritol powder air‐polishing (EPAP) (i) as an adjunctive during active periodontal therapy (APT) and (ii) as an alternative to hand/ultrasonic instrumentation during supportive periodontal therapy (SPT). Additionally, microbiological outcomes and patient's comfort/perceptions were assessed as secondary outcomes.
PubMed, Cochrane and Medline were searched for relevant articles published before February 2021 following PRISMA guidelines. The search was conducted by three indep
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Abstract Portable communication devices such as WLAN, WiMAX, LTE, ISM, and 5G utilize one or more of the triple bands at (2.32.7 GHz,3.4–3.6GHz,and5–6GHz)andsufferfromtheeffectofmultipathproblemsbecausetheyareusedinurbanregions.To date, no one has performed a review of the antennas used for these types of wireless communications. This study reviewed two types of microstrip antennas (slot and fractal) that have been reported by researchers (as a single element) using a survey that included the evaluation of several important specifications of the antennas in previous research, such as operating bandwidth, gain, efficiency, axial ratio bandwidth (ARBW), and size. The weaknesses in the design of all antennas were carefully identified to de
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The outbreak of a current public health coronavirus 2019 disease is a causative agent of a serious acute respiratory syndrome and even death. COVID-19 has exposed to multi-suggested pharmaceutical agents to control this global disease. Baricitinib, a well-known antirheumatic agent, was one of them. This article reviews the likely pros and cons of baricitinib in attenuation of COVID-19 based on the mechanism of drug action as well as its pharmacokinetics. The inhibitory effect of baricitinib on receptor mediated endocytosis promoter, AKK1, and on JAK-STAT signaling pathway is benefacial in inhibition of both viral assembling and inflammation. Also, its pharmacokinetic has encouraged the physicians toward the drug
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