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 current study was designed to evaluate the anti-inflammatory effect of GKB in the rat model of granulomatous inflammation. Thirty rats were distributed into five groups: The first group served as negative control group that received distilled water (DW) only without inducting inflammation, positive control group; treated with DW with the induction of inflammation and they were assigned to cotton pellet-induced granuloma, ginkgo biloba (GKB) treated group (200mg/kg/day), dexamethasone-treated group (1mg/kg), and Prednisolone treated group (5mg/kg). All the treatments were given orally for seven consecutive days. On day eight, the rats were anesthetized and the pellets together with granulation tissue were carefully removed
... Show MoreDiabetes mellitus is a chronic illness that commonly leads to progressive and incapacitating of patients’ condition over the past 20 years.
The aim of the study was to evaluate the effects of the coughing technique, ShotBlockerTo evaluate the effects of the coughing technique, ShotBlocker and vibration device on pain intensity and patient satisfaction during subcutaneous (SC) insulin injections in hospitalised adults with Type 2 diabetes mellitus (T2DM).
Summary:
This research revolves around the probing of those whom Ibn Hajar said, "He has a vision", its significance, and the ruling on the connection and transmission to it. The number of narrators reached fifty-one (51) narrators, among whom it was said, “He has a vision, whether it is definite or possibly. Some of them had a vision and companionship.”They are eleven (11) narrators, And among them were those who had visions and had no company, and their number was twenty-one (21) narrators, and among them were those who had no vision and nor company, and their number is nineteen (19) narrators.
As a result , whoever said about him “has a vision” and has companions, his hadith is connected, even i
The study aims to build a proposed training program for school leaders in the Sultanate of Oman on the planning practices of the Kaufman model in light of the needs and challenges of reality. It also aims to identify the challenges facing school leaders in practicing the stages of strategic planning. To achieve these objectives, the study adopted the descriptive approach due to its suitability to the nature of the study. A questionnaire was used to collect the needed data. The study sample included (225) individuals from school principals, their assistants and senior teachers in post-basic education in the Sultanate of Oman. After processing the data statistically, the study concluded that the reality of planning practices for school lea
... Show MoreThe subject of social capital is of great importance, as it provides an analytical framework for researchers interested in understanding the impact of the Internet on many dimensions of human and social life. And because social networking sites have infiltrated societies and produced new variables at the level of human and social communication, this study came to examine the relationship between the use of the social networking site Facebook and the accumulation of social capital among a sample of University of Algeria 3 students, by researching the variables of intensity of use and patterns of use as independent variables and their relationship to social capital. The results of the field study revealed a strong relationship between the
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Typological analysis about the negation marker in different languages is one of the fields of research that has attracted much attention. In Persian language, this constituent has been analysed from different aspects. This study aimed to analyse different aspects of negation marker in the adjectives, the noun phrases and the verb phrases based on typological analysis. Many studies have been revealed that the negation in adjectives has shown lexically and morphologically. In the noun phrases, /hich/ has used as a negative marker necessarily marking the verb phrase as negative too. In the verb phrases, negation occurs morphologically by the addition of the prefix /n
... Show MoreThe purpose of this paper is to identifying the values of some physical and Bio- Kinematic variables during the performance of the jump spike serve skill, and identifying the effect of the proposed training program using intermittent training to develop some physical and Bio- Kinematic variables and accuracy of the jump spike serve skill among the research sample. The experimental method was used and the research was conducted on a deliberately chosen sample of the players of the Army Club, who were primarily advanced in volleyball, and the number of the sample was (10) players. The conclusions were reached that the proposed training program using intermittent training has a positive effect on some of the physical and Bio- Kinematic variabl
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