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.
which is much useful in the Arabic Language generally in the Holly Quran especially. It is the pronoun I have taken in the semantic aspect from it and I have done on the surra sabba which varities the semantical pronoun in it among the pronoun of the speaker the conscience of the addressee the absent such the the siprat pronoun that comes in it with the explanation for its importance and its work and this is the subject of the first unit which I advanced it from the concept of the pronoun Linguistically and convention. After that I have lighten in some meanings which I have done in the surrat as a semantic , magnification , proud, reprimand and others which I ended my research I have reached the results from it
... Show MoreObjective: To assess role of obesity in Covid-19 patients on antibodies production, diabetes development, and treatment of this disease. Methodology: This observational study included 200 Covid-19 patients in privet centers from January 1, 2021 to January 1, 2022. All patients had fasting blood sugars and anti-Covid-19 antibodies. Anthropometric parameters were measured in all participants. Results: The patients were divided into two groups according to body weight; normal body weight (50) and excess body weight (150). There was a significant difference between them regarding age. Diabetes mellitus developed in 20% of normal weight patients while 80% of excess weight patients had diabetes (p=0.0001). Antibodies production (IgM and
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Recently, all over the world mechanism of cloud computing is widely acceptable and used by most of the enterprise businesses in order increase their productivity. However there are still some concerns about the security provided by the cloud environment are raises. Thus in this our research project, we are discussing over the cloud computing paradigm evolvement for the large business applications like CRM as well as introducing the new framework for the secure cloud computing using the method of IT auditing. In this case our approach is basically directed towards the establishment of the cloud computing framework for the CRM applications with the use of checklists by following the data flow of the CRM application and its lifecycle. Those ch
... Show MoreABSTRACTBackground: In Medical ethics education, improving medical student’s attitudes toward respecting the right of patients is an essential task. The medical students’ attitude has been affected by social, educational and personality background factors.Objective: To investigate medical student’s attitudes regarding medical ethics courses.Method: The study was conducted in Al-Kindy College of Medicine on academic year (2013 -2014) for the period from January to September. A cross- sectional study design was adopted with a self- administered questionnaire form distributed to medical students in the 5th-6th under graduate grades. The questionnaire consisted of 31 items relevant to student’s opinion about attitudes concerning ethi
... Show MoreThe aim of the present study is to evaluate the effectiveness of using Art as therapy to reduce the symptoms of Attention Deficit Hyper Activity Disorder (ADHD), in primary school children.
A clinical approach was used to test the validity of the hypothesis of our study, conducted on two second and fourth-year primary school pupils from Algiers, aged 7 and 9 years respectively.
In addition to the clinical observation and interview, we made use of the "Conners" scale for a (pre and post intervention) ADHD assessment, consisting of a combination of Art media in the form of mosaic works on purposely prepared panels. After 10 therapy sessions, results revealed the effectiveness of Art therapy in reducing ADHD in primary education
Developing an efficient algorithm for automated Magnetic Resonance Imaging (MRI) segmentation to characterize tumor abnormalities in an accurate and reproducible manner is ever demanding. This paper presents an overview of the recent development and challenges of the energy minimizing active contour segmentation model called snake for the MRI. This model is successfully used in contour detection for object recognition, computer vision and graphics as well as biomedical image processing including X-ray, MRI and Ultrasound images. Snakes being deformable well-defined curves in the image domain can move under the influence of internal forces and external forces are subsequently derived from the image data. We underscore a critical appraisal
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The theory of Pilgrims in the Magra is based on Dekru's view that the mgha is considered a pilgrim, and that the pilgrims are pilgrims
Tujia purely exposes the abstract temptation structure, and that the discharge of the Mfezouz Mfarouz is through factors
This theory tends to highlight the role of pilgrim function as a language
There is no preservation unless directed towards a particular outcome. Gemma can include morphine blindness
Or formulas that allow for the presentation of a pilgrimage to a writer in addition to the content of the news, and the guidance of the recipient
In one direction or another.
The orbital masses are one of these morphines and functional components that achieve function
The Togolese
It is easy to talk about democracy, but it is difficult to practice. We talk about postmodernism, but difficult to be embodied in the ground. Yet, the age of democracy and modernity at the same time prompted the researcher to try to find a media concept for it. It does not mean that this concept has not yet formed. But the rooting of democracy and the approaching of states and groups towards it, made it necessary to by studied again.
The relationship between democracy and the media has made them look like one concept. The existence of one is linked to the existence of the other. The reality is only a linguistic formulation, but the social and cultural aspect is related to democracy origin
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Polyaniline organic Semiconductor polymer was prepared by oxidation polymerization by adding hydrochloric acid concentration of 0.1M and potassium per sulfate concentration of 0.2M to 0.1M of aniline at room temperature, the polymer was deposited at glass substrate, the structural and optical properties were studies through UV-VIS, IR, XRD measurements, films have been operated as a sensor of vapor H2SO4 and HCl acids.