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.
Abstract
were determine the problem of current research to answer the question on the consciousness of the Ministry of Agriculture to adopt Staffing strategy and identify the shortcomings as the independent variable, represented by the three dimensions (recruitment , selection, placement) and its impact on high performance, as dependent variable is described in four dimensions (leadership, strategy, structure and processes, culture), in this research were Used analytical descriptive style . This research aims to identify the correlation and impact of Staffing strategy at high-performance in Ministry of Agriculture , To clarify the relationship between
... Show MoreBackground: Ruptured posterior communicating artery (PCoA) aneurysms are common; they usually present with subarachnoid haemorrhage (SAH) and oculomotor nerve palsy. The aneurysmal dome projection may influence the safety access and aneurysmal neck clipping. Here, we discuss additional intraoperative steps that may be required to widen the surgical field to ensure safe surgical clipping of a rupture pure posteriorly directed PCoA aneurysm. Case description: A previously healthy 38-year-old male reported sudden severe headache and disturbed level of consciousness with a Glasgow coma scale (GCS) of 13. His initial computed tomography (CT) scan of the head showed SAH in the basal cistern. 3D-constructed CT angiography (CTA) revealed a
... Show MoreTemporomandibular Disorders (TMD) refer to a group of symptoms where pain is the most leading cause to demand a treatment by the patient. Light therapies are of great importance at current times due to its biosafety and non-invasive quality when used for the management of TMD symptoms. This study aimed to evaluate the efficacy of red LED light with low-level LASER in treating TMD patients.
A double-blind randomized clinical study was conducted and included 60 patients along 3 groups (20 for e
The aim of this study was to evaluate the risk factors that influence the perforation, regardless of the presence of H. pylori infection, in a sample of Iraqi patients with peptic ulcers, admitted to Al-Kindy Teaching Hospital. A total of 90 patients who had perforated peptic ulcer participated in this study. The diagnosis was based on history, clinical examination, laboratory and radiological investigations and was confirmed intraoperatively. A number of probable risk factors for perforation were investigated. Eighty participants were males and 10 were females (male to female ratio 8:1). About 42.2% of patients were in their fifth decade of life. Forty-nine (54.4%) patients were asymptomatic be
The aim of the work is synthesis and characterization of bidentate ligand [3-(3-acetylphenylamino)-5,5-dimethylcyclohex-3-enone][HL], from the reaction of dimedone with 3-amino acetophenone to produce the ligand [HL], the reaction was carried out in dry benzene as a solvent under reflux. The prepared ligand [HL] was characterized by FT-IR, UV-Vis spectroscopy, 'H, 8C-NMR spectra, Mass spectra, (C.H.N) and melting point. The mixed ligand complexes were prepared from ligand [HL] was used as a primary ligand while 8-hydroxy quinoline [HQ] was used as a secondary ligand with metal ion M(IT).Where M(IT) = (Mn ,Co ,Ni ,Cu ,Zn ,Cd and Pd) at reflux ,using ethanol as a solvent, KOH as a
... Show MoreThe present work represents a theoretical study for the correction of spherical aberration of an immersion lens of axial symmetry operating under the effect of space charge, represented by a second order function and preassigned magnification conditions in a focusing of high current ion beams. The space charge depends strongly on the value of the ionic beam current which is found to be very effective and represents an important factor effecting the value of spherical aberration .The distribution of the space charge was measured from knowing it's density .It is effect on the trajectory of the ion beam was studied. To obtain the trajectories of the charged particles which satisfy the preassined potential the axial electrostatic potential w
... Show MoreCefixime is an antibiotic useful for treating a variety ofmicroorganism infections. In the present work, tworapid, specific, inexpensive and nontoxic methods wereproposed for cefixime determination. Area under curvespectrophotometric and HPLC methods were depictedfor the micro quantification of Cefixime in highly pureand local market formulation. The area under curve(first technique) used in calculation of the cefiximepeak using a UV-visible spectrophotometer.The HPLC (2nd technique) was depended on thepurification of Cefixime by a C18 separating column250mm (length of column) × 4.6 mm (diameter)andusing methanol 50% (organic modifier) and deionizedwater 50% as a mobile phase. The isocratic flow withrate of 1 mL/min was applied, the temper
... Show MoreObjective: To identification environmental and psychological violence's components among collegians’ students of different stages, and gender throughout creating specific questionnaire, and estimating regression of environmental domain effect on psychological domain, as well as measuring powerful of the association contingency between violence's domains in admixed form with respondent characteristics, such that (Demographics, Economics, and Behaviors), and extracting model of estimates impact of studied domains in studying risks, and protective factors among collegians’ students in Baghdad city. Methodolog