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.
The aim of this study was to critically appraise and synthesize the best available evidence on the effectiveness of interventions suitable for delivery by nurses, designed to enhance cardiac patients' adherence to their prescribed medications.
Cardiac medications have statistically significant health benefits for patients with heart disease, but patients' adherence to prescribed medications remains suboptimal.
A systematic quantitative review of intervention effects.
Recent reports of new pollution issues brought on by the presence of medications in the aquatic environment have sparked a great deal of interest in studies aiming at analyzing and mitigating the associated environmental risks, as well as the extent of this contamination. The main sources of pharmaceutical contaminants in natural lakes and rivers include clinic sewage, pharmaceutical production wastewater, and sewage from residences that have been contaminated by drug users' excretions. In evaluating the health of rivers, pharmaceutical pollutants have been identified as one of the emerging pollutants. The previous studies showed that the contaminants in pharmaceuticals that are widely used are non-steroidal anti-inflammatory drugs, ant
... Show MoreThe cyanobacterial neurotoxin
A vocative expression can be defined as an expression of direct address where the participant identity is set forth explicitly within a sentence. This study aims at showing how the vocative particles are used in literally texts, namely in the short story “The Garden Party" written by Kathryn Mansfield and identifying the forms of these vocative particles as used by the characters along with the functions of these vocative particles. For the analysis of vocative forms, the researcher used Quirk and Greenbaum (1973) model. Functionally, the data were analyzed based on Quirk et al. (1985) model. However, the results of this study shows that the characters in “The Garden Party” short story used various forms of vocative particles and
... Show MoreThe content of Furocoumarin derivatives (Psoralens) of Ruta Chalepensis L. (Whole plant) was studied by simple extraction with petroleum ether (b.p. 60-80Co). The results indicated that the plant contains a total of about (0.015%).
Investigation of these compounds by thin layer chromatography (TLC) revealed the presence of at least four compounds of which methoxsalen (8-methoxypsoralen) was isolated. It was identified and authenticated with a standard by spectral method, IR, NMR, Mass spectra and HPLC.This plant could be considered as a good source for supplying this compound, which is widely used in dermatological preparations.
The purchase of a home and access to housing is one of the most important requirements for the life of the individual and the stability of living and the development of the prices of houses in general and in Baghdad in particular affected by several factors, including the basic area of the house, the age of the house, the neighborhood in which the housing is available and the basic services, Where the statistical model SSM model was used to model house prices over a period of time from 2000 to 2018 and forecast until 2025 The research is concerned with enhancing the importance of this model and describing it as a standard and important compared to the models used in the analysis of time series after obtaining the
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