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.
Artificial intelligence has quickly invaded the realms of both creative and information-based writing, raising new questions about human originality, authorship and style. Despite its ability to produce writings that are coherent and stylistically varied, there are still concerns over the uniqueness and cultural neutrality of AI programs such as ChatGPT. This review covers significant recent advancements with artificial intelligence applications in both the literary and non-literary fields. It analyzes 35 recent studies contrasting authorship and creativity, or stylistic considerations and impressions, between human and AI texts. These studies range from poetic and fictional writing through essay, news article and academic publicati
... Show MoreThe study objective was to summarize and evaluate the literature from the last decade about the cost of illness (COI) of diabetic retinopathy (DR) and diabetic macular edema (DME) through a systematic review.
Author conducted a search of the PubMed, and Google Scholar, electronic databases from January 2014 until July 2024, by identifying the following keywords ‘cost of illness,’ ‘economic burden,’ ‘diabetic retinopathy,’ and ‘diabetic m
In this review, numerous analytical methods to distinguish pigments in tattoo, paint, and ink items are discussed. The selection of a method was dependent upon the purpose, e.g., quantification or identification of pigments. The introductory part of this review focuses on describing the importance of setting up a pigment-associated safety profile. The formation of different degradation chemical substances as well as impurity trends can be indicated through the chemical investigation of pigments in tattoo products. It is noteworthy that pigment recognition in tattoo inks can work as a preliminary method to identify the pigments in a patient's tattoo before being removed by laser therapy. Contrary to the stud
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
... Show MoreThis research a mining at evaluation the efficiency of the nursing performance depended on standards of W.H.O. via application standards of W.H.O on the nursing personnel in medical city office, in light of it, it has design world evaluation list, and a sample was chosen from the nursing personnel in given researched the organization whom they are evaluated according to the standards of W.H.O for the nursing performance included of ten standards, divided in to 45 question , besides the evaluation list, the researcher get assistance of some tools of collection information via actual checking and personal interviews, a number of statistical means were used to manipulate t
... Show MoreThe Present study aims at answering the following questions:
1-What is the level of the teaching style of biology teachers who teach (human and his
health)
2-what is the level of healthy attitude to the teachers of biology who teach (human and his
health).
3- is there any relation between the teaching style of biology teachers who teach (human and
his health)and their student's Ability Mind.
4- is the any relation between the level of the healthy attitude to the teachers of biology who
teach (human and his health).
The researcher made the following for the purpose of answering the question of the study:
1-The card of observing the level of the teaching style (lecture style )to the teachers of
biology