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.
This work discusses the beginning of fractional calculus and how the Sumudu and Elzaki transforms are applied to fractional derivatives. This approach combines a double Sumudu-Elzaki transform strategy to discover analytic solutions to space-time fractional partial differential equations in Mittag-Leffler functions subject to initial and boundary conditions. Where this method gets closer and closer to the correct answer, and the technique's efficacy is demonstrated using numerical examples performed with Matlab R2015a.
This research explores the concept of cruel optimism in the context of challenging patriarchal, cultural, and social traditions in Ayad Akhtar’s The Who and the What. Cruel optimism, a term coined by Lauren Berlant, refers to the paradoxical attachment to positive aspirations that may ultimately obstruct personal fulfillment and well-being. This study examines how individuals who resist patriarchal norms and entrenched cultural traditions often face significant emotional, psychological, and social challenges. Through a multidisciplinary approach, including literary analysis, sociological perspectives, and psychological insights, the research delves into the lived experiences of those who strive for autonomy, equality, and self-realization
... Show MoreThe present study deals with the effect of self -observation on EFL University students` achievement in conversation classes. The process of self-observation helps the teacher to understand one’s own actions and the reactions in the process of teaching. The sample of this study is EFL students in the third stage at the Department of English Language, morning studies, College of Education /Ibn-Rushd .The sample of the study consists of (84) students distributed on experimental group(A) includes (42) students, and (42) students as control group(B). In order to achieve the aim of the study ,and to gain a closer idea about the impact of reflective teaching technique(self-observation) on the students achievement in conversation classes, a chec
... Show MoreBackground: In Iraqi communities, the workers considered the largest population groups, so increasing their dental education by increasing the care for their dental health knowledge and behavior is very important, the present study was aimed to evaluate the gingival health and oral hygiene in relation to knowledge and behavior among a group of a workers selected randomly from Al Fedaa company in Baghdad city. Materials and methods: A sample of 110 workers (65 men and 45 women) included in this study, a questionnaire used to evaluate their oral health knowledge and behavior. The gingival health condition of the workers was examined by using Loe and Silness index (1963), Silness and Loe index (1964) was used to asses plaque quantity, and Ramf
... Show MoreIn 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
This research is based on the descriptive and analytical methodology. The importance of studying labor laws and labor unions in Japan between 1889 and 1946 constitutions is because Japan was out of a feudal phase, and had no idea about the factory system and industrialization in their modern sense before the Meiji era. Generally, its labor system used to be mostly familial, and the economic system was based on agriculture. This called for the enactment of legislations and laws appropriate for the coming phase in Meiji era. Thus, this paper examines the role of Meiji government in enacting labor legislations and laws when he came to power in 1896, and his new constitution in 1889 and the civil code of 1896. It further examines the way Mei
... Show MoreThe posterior regions of the jaws usually represent a significant risk for implant surgery. A non-valid assessment of the available bone height may lead to either perforation of the maxillary sinus floor or encroachment of the inferior alveolar nerve and consequently to implant failure. This study aimed to evaluate the reliability of surgeon’s decision in appraising the appropriate implant length, in respect to vital anatomical structures, using panoramic radiographs.
Only implants that are inserted in relation to the maxillary sinus (MS) or the mandibular canal (MC) were enrolled