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 surgeryKeywords: Non-surgical treatment of anal fissure, fissure in ano, sphicterotomy,botulinum toxin in anal fissures, glyceryl trinitrate. Chemical sphincteratomy, pharmacological sphincteratomy.
KE Sharquie, AA Noaimi, WK Al-Janabi, Journal of Cosmetics, Dermatological Sciences and Applications, 2013
Abstract: Residual ridge resorption is chronic, progressive, irreversible and cumulative condition associated with teeth loss. Management of a residual ridge with severe resorption to fulfill the patient’s esthetic and functional requirements is quite difficult for the practitioner and also in the construction of an acceptable appliance. As the height of the edentulous ridge reduces the mandibular denture will be improperly function. Severe resorption of the mandibular alveolar ridge may cause instability and discomfort of the convention acrylic resin denture. Dealing with this condition requires clinical skills and knowledge. Treating the severely resorbed mandibular ridge is a challenging effort for prosthodontics. This research present
... Show MoreThe world is currently challenging the serious effects of the pandemic of the Coronavirus disease (COVID-19) caused by severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2). Data on pediatric COVID are rare and scattered in the literature. In this article, we presented the updated knowledge on the pediatric COVID-19 from different aspects. We hope it will increase the awareness of the pediatricians and health care professionals on this pandemic.
At the beginning of the twentieth century distorting handling totalitarian phenomena of art, which can be called the stage of the test, transition from the theory of ideal theory and other realistic is not cushy, since it requires vision and reading and other concepts, and in light of this dialectic manifested research problem by asking the following Is affected by the design idealism and realism. Through the above mentioned questions, the researcher found rationale for addressing this problem, the study through his research, which is marked (idealism and realism in a comparative study design). And demonstrated the importance of research in the identification of the concept and the effectiveness of the two theories idealism and realism a
... Show MoreLet be a ring. Given two positive integers and , an module is said to be -presented, if there is an exact sequence of -modules with is -generated. A submodule of a right -module is said to be -pure in , if for every -Presented left -module the canonical map is a monomorphism. An -module has the -pure intersection property if the intersection of any two -pure submodules is again -pure. In this paper we give some characterizations, theorems and properties of modules with the -pure intersection property.
the pursue of social systems history present to us solid evidence that the collapse of that systems be caused by either the stagnancy aftermath maturity or unreal intellectual foundation which lead to sudden collapse, while the capitalism can avoided that intellectual damages due to its dynamic system with appropriate auto adaptation mechanism and use it excellently in the right time.
The globalization had excrete (as one of the capitalism adaptation mechanism) its own targets and its methods in framework of multinationals corporations which consist with capitalism states that employed the international organizations to reconstruction the global economy to serve such targets. So the glob
... Show MoreCNC machines are widely used in production fields since they produce similar parts in a minimum time, at higher speed and with possibly minimum error. A control system is designed, implemented and tested to control the operation of a laboratory CNC milling machine having three axes that are moved by using a stepper motor attached to each axis. The control system includes two parts, hardware part and software part, the hardware part used a PC (works as controller) connected to the CNC machine through its parallel port by using designed interface circuit. The software part includes the algorithms needed to control the CNC. The sample needs to be machined is drawn by using one of the drawing software like AUTOCAD or 3D MAX and is saved in a we
... Show MoreThe sensitive and important data are increased in the last decades rapidly, since the tremendous updating of networking infrastructure and communications. to secure this data becomes necessary with increasing volume of it, to satisfy securing for data, using different cipher techniques and methods to ensure goals of security that are integrity, confidentiality, and availability. This paper presented a proposed hybrid text cryptography method to encrypt a sensitive data by using different encryption algorithms such as: Caesar, Vigenère, Affine, and multiplicative. Using this hybrid text cryptography method aims to make the encryption process more secure and effective. The hybrid text cryptography method depends on circular queue. Using circ
... Show More