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.
Summary
The book (Fatah al-Rahman reveals what is ambiguous in the Qur’an), which is a book of verbal similarities that tries to touch the Qur’an expression, and the subtle differences between its expressions and expressions. It appeared when it appeared in many chapters, from which I chose to delete in monolithic letters such as Ba and Ta, and to heal and delete in non-monosymbols such as (that) and (may) and (no), so the search came to two chapters The first is for deleting the monolithic letters, and the second is for deleting non-monosyllabic letters, preceded by introductory discussions revolving around the linguistic and idiomatic definition of deletion, a brief translation of the
... Show MoreThis research investigates the meanings and significance of the verse and the concluded educational purports. The expression “And in the heaven is your provision” signifies the deism of Allah. This research introduces the what have been said by Quran Explainers about meaning of Heaven & Provision. It introduces also the meaning of the sentence “which you are promised” and its concluded educational purports. This research discuses the role of educational institutions as well as the family and mosques in connecting Muslims and their children with the promise given by Allah.
Provision is guaranteed for all people if moral and material causes have been considered.
Key Words:
Purports – Educational – Co
... Show MoreThe focus of this research revolves around the importance level of sialic acid in the reasoning of cases, including tumors and then evaluate the patient's response to treatment and its impact on the immune response there are a lot of evidence showing that parts Alkrbu ???????? in peptides sugary and glycoproteins play an important role in Alfalitin life and responsiveness
Objective: To find out the relationship between vaginal bleeding during third trimester and pregnancy outcomes. Methodology: A purposive sample is "Non-probability" of (100) women who had diagnostic vaginal bleeding during third trimester (27-40wk) of pregnancy, and who visited the Bint Al-Huda Hospital for the period from 15th Feb. to 17th May 2015.Validity and reliability of questionnaire are determined through pilot study. Descriptive and inferential statistical procedures were used to analyze the data, and the data were collected by using interview technique, constructed questionnaire has been desig
In this work the strain energy of tetrahedrane and its nitrogen substituted molecules were calculated by isodesmic reaction method according to DFT quantum chemical fashion, the used basis set was 6-31G/B3-LYP, in addition all structures were optimized by RM1 semi-empirical method. From the obtained data we estimate an empirical equation connect between strain energy of the molecule with charge functions represented by dipole moment of the molecule plus accumulated charge density involved within the tetrahedron frame plus the number of nitrogen atoms. The results indicate the charge spreading factors by polarization and processes are the most important factors in decreasing the strain energy.
The field study of this paper focused on the motives for lawyers to use the website
of the Supreme Judicial Council, and the gratifications achieved as a result of its use.
This study sought to achieve a number of goals, including:
1. Monitoring the patterns of lawyers’ use of the website of the Supreme Judicial Council.
2. Determining the forms that lawyers use to interact on the website of the Supreme
Judicial Council.
This study is a descriptive in kind as the researcher relied on the ‘survey method’ in
its study of the external audience (lawyers) using the questionnaire and scale toolThe questionnaire was distributed among a deliberately chosen sample, consisting of
(160) lawyers who used the website of
This research aimed to definite Blending learning (BL) technique, and to know the impact of its use onacademic achievement in Biology course of second class students in secondary special schools in Omdurman Locality and attitudes towards it, to achieve this; researcher adopted the experimental method. The sample was selected of (41) students, chosen from Atabiyah school, were divided into two equals groups: one experimental group reached (26) students studied by using the BL technique, and the second control group (25) students have been taught in the traditional method.
Data has collected by using two tools: achievement test and a questionnaire for measuring the attitudes towards Blend
... Show MoreNonalcoholic fatty liver disease (NAFLD) is a common liver disease that ranges from simple steatosis to nonalcoholic steatohepatitis (NASH). So far, the underlying mechanism remains poorly understood. Here, we show that hepatic carboxylesterase 2 (CES2) is markedly reduced in NASH patients, diabetic
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Klebsiella pneumoniae is among the most frequent microorganisms isolated from infections of burn wounds. This cross-sectional study aimed to investigate the distribution of multi-drug resistant (MDR) K. pneumoniae in two burn hospitals and the antibiotic resistance profile in different burn regions of the same patient. It was performed in two hospitals (Al-Zahraa and Al-Karama) in Al-Kut, Iraq, between January and May 2022. Totally, 100 burn swabs were collected from 40 patients of both genders suffering from burn wound infections, with ages ranging between 3 and 50 years. Klebsiella pneumoniae were isolated and identified using conventional methods followed by VITEK®2 system and confirmed via polymerase chain reaction targeting t
... Show MoreI dealt with this study of one of the hadiths of the Prophet and judged him after studying his deed, especially one of his narrations for the similarity in his name and the name of his father (Abdul Rahman bin Ishaq) Is he a civil "Sadok" or Wasti "weak" and they are in one layer which is called in the science of Hadith (agreed And after a review of Kutkut translations and wound and amendment and other evidence and evidence that it was "weak" and not as he went to him and asserted by the updated Muhammad Nasser al-Din al-Albani may God have mercy on him that in Sindh is a civil rule for the hadeeth "Hassan" and not as said The hadeeth is “weak” because he showed that it is the weak Wasti.
I ask God to be successful in this work an