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.
This study looks into the many methods that are used in the risk assessment procedure that is used in the construction industry nowadays. As a result of the slow adoption of novel assessment methods, professionals frequently resort to strategies that have previously been validated as being successful. When it comes to risk assessment, having a precise analytical tool that uses the cost of risk as a measurement and draws on the knowledge of professionals could potentially assist bridge the gap between theory and practice. This step will examine relevant literature, sort articles according to their published year, and identify domains and qualities. Consequently, the most significant findings have been presented in a manne
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Background: Thyroid surgery is most common endocrine surgery in general surgical practice. Objectives: the aim of this work is to evaluate the feasibility, benefits and outcomes of open mini-incision thyroidectomy and compared the results with that of conventional thyroidectomy. The comparison between the two groups was in term of incision length, amount of blood loss, time of operation, postoperative pain, hospital stay and the cosmetic outcomes.Type of the study: this is a single-blinded randomized controlled studyMethods: This study compared the advantages and outcomes of 22 patients subjected to mini-incision thyroidectomy (Group A) with the equal numbers of patients subjected to conventional thyroidectomy (Group B).Results: the oper
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Citric acid is an essential ingredient for the manufacture of (12) key industrial chemicals. Citric acid use is increasing steadily with a high annual growth rate as a result of the development of ever more sophisticated applications. Citric acid is widely utilized in the food and pharmaceutical industries due to its low toxicity when compared to other acidulous. Other uses for citric acid can be found in cleaning supplies and detergents. Based on information from a review of the literature, Citric acid production substrates and methods for surface fermentation, submerged fermentation, solid-state fermentation, and international market expansion are all covered in the current review study. Finally, there is still much to learn about the
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تعد مراجعة النظير واحدة من الأســاليب الحديثة فــي مجال الرقابة والتدقيق ونشــأة كأداة لقياس مــدى فاعليــة الرقابــة علــى الجــودة هو لبنة أساسية في إدارة الجودة الشاملة ووسيلة لتحســين أدوات الرقابــة المعمول بها، وللتحقق من مدى الانسجام بين المعايير الدولية للأجهزة العليا للرقابة المالية والمحاسبة والاجراءات المعمول بها من قبل الاجهزة العليا للرقابة وعليه فأن مراجعة النظير أداة تستخدم ف
... Show MoreThe paper is highlighting the athletics and heroic sports which encouraged and played at Greek and Islamic period. The paper is identifying the Islamic athletics and heroic sport and compare them with Greek sports, as it is the model of sports while the sport during the Islamic period was not undertaken by scientific researches or articles even in Wikipedia. Although, this period was encouraged and practice many sports such as archery, sword grappling and wrestling, equestrianism, jogging and running whereas there are many Arabic references revealed during the Islamic 610 A.D. while the Greek and Olympic was known at 732 A.D. The paper is followed the literature review and historical to shied a light scientifically about traditional sports
... Show MoreAntibiotics are essential for treating infectious diseases, but their overuse and adverse effects are raising concerns about global public health. The pervasiveness of antibiotic contamination in aquatic environments has drawn increased attention in recent years. The primary concern regarding the release of antibiotics into the environment is the potential for microorganisms to become resistant to antibiotics. This review article summarizes the analytical methods used to determine the presence of trimethoprim and metronidazole in various environmental samples. These antibiotics have traditionally been analyzed using tandem mass spectrometry or high-performance liquid chromatography coupled to mass spectrometry; fluorescence or ultrav
... Show MoreCurrently, there is an intensive development of bipedal walking robots. The most known solutions are based on the use of the principles of human gait created in nature during evolution. Modernbipedal robots are also based on the locomotion manners of birds. This review presents the current state of the art of bipedal walking robots based on natural bipedal movements (human and bird) as well as on innovative synthetic solutions. Firstly, an overview of the scientific analysis of human gait is provided as a basis for the design of bipedal robots. The full human gait cycle that consists of two main phases is analysed and the attention is paid to the problem of balance and stability, especially in the single support phase when the biped
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The field study of this paper focused on the motives for lawyers to use the website
of the Supreme Judicial Council, and the gratifications achieved as a result of its use.
This study sought to achieve a number of goals, including:
1. Monitoring the patterns of lawyers’ use of the website of the Supreme Judicial Council.
2. Determining the forms that lawyers use to interact on the website of the Supreme
Judicial Council.
This study is a descriptive in kind as the researcher relied on the ‘survey method’ in
its study of the external audience (lawyers) using the questionnaire and scale toolThe questionnaire was distributed among a deliberately chosen sample, consisting of
(160) lawyers who used the website of
This research aimed to definite Blending learning (BL) technique, and to know the impact of its use onacademic achievement in Biology course of second class students in secondary special schools in Omdurman Locality and attitudes towards it, to achieve this; researcher adopted the experimental method. The sample was selected of (41) students, chosen from Atabiyah school, were divided into two equals groups: one experimental group reached (26) students studied by using the BL technique, and the second control group (25) students have been taught in the traditional method.
Data has collected by using two tools: achievement test and a questionnaire for measuring the attitudes towards Blend
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