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.
Gabriel Garcia Marquez, the Nobel laureate of literature in 1982, is one of the most famous Latin American writers who have been distinguished by the magic of realism. We can say the months in the world and he is almost the most controversial for many reasons and for these reasons he did not accept that his novels turn into movies Marquez agreed to turn one of his most important and most beautiful novels, "Love in the Time of Cholera," which he wrote in 1985 and agreed to convert to a film in 2006 after the novel was bought by the author for $ 3 million. Mike Noel to bring out
The issue of freedom is the most prominent and distinctive issue of Western thought, which it reached after a long struggle. The English thinker John Stuart Mill is considered the most prominent Western thinker who elaborated on the issue of freedom, until his ideas on the issue of freedom became the semi-final formula for issues of freedom in Western thought, which revolve in their entirety on The individual has complete freedom as long as it does not harm others, and this freedom is controlled by law.
And if the freedoms he offered were not considered an achievement in Western thought; Freedom in Islam is a central and fundamental issue, and the details of freedoms in Islam have not been accomplished by anyone, but rather came
... Show MoreA legal discourse in the Qur’an and Sunnah is almost devoid of the use of one of the general formulas, and due to its frequent rotation in the tongue of the legislator, the formulas may overlap their members in apparently contradictory provisions, which makes the individual from the general members appear to the beholder to be covered by two contradictory provisions, and this research came to present what might happen to him The legal text interpreter of weighting between the two opposing texts is the strength of the generality that is established by the generality formula, so the two strongest formulas in the inclusion of its members outweigh the weaker of them and precede them, and the research decided that the formulas vary
... Show MoreThe role of relaxation program for reducing anxiety of patients in dental clinic
The aim of this project was to study the in vitro effect of antineoplastic drugs (vincristine and vinblastine) on mice spermatozoa. Eighteen adult (age 8-9 weeks) male mice were divided into three groups equally. The animals in each group were slain by cervical dislocation, the testes were removed and two tails of epididymides isolated. Spermatozoa were obtained from the two tails of epididymides by mincing in 500 µl TCM-199.The first group non-treated (unadded) as a control group, second group added 10 µg/ml of vincristine to TCM-199 and the third group added 10 µg/ml of vinblastine to TCM-199. After 10 minutes from added of vincristine and vinblastin measured the following test: spermatozoa activity, percentage dead spermatozoa and mor
... Show MoreAll the available reports on the issue of infertility confirmed the increase in this population problem worldwide. Although the accurate estimate of the number of infertile people is due to several reasons, including the discrepancy in the true definition of infertility (whether it extends for one, two or five years of failed pregnancy attempts), as well as the great discrepancy in the size of the selected population groups (large population sample size versus epidemiological studies) and defining the category that diagnosed included (individuals, women, or couples). The goal of today’s IVF program is to obtain high-quality embryos with high efficiency in development, which leads to an increase in live birth rates.
يتنامى يوما بعد يوم استخدام السيارات وتتعاضم اعدادها ، فهذا هو عصر السرعة، وخاصة في مجال النقل والمواصلات، والتي تتحقق باستخدام وسائل النقل المختلفة ومن بينها السيارات، وبالتالي اصبحت هذه الوسيلة ضرورية لتحقيق هذه السرعة ومن ضرورات الحياة في انجاز الاعمال.
وتتبارى مصانع السيارات فيما بينها لانتاج انواع السيارات بمواصفات عالية من المتانة والامان والراحة، وفي ذات الوقت اصبحت هندسة الطرق
... Show MoreAbstract---The aim of the current research is to identify the level of logical reasoning skills in chemistry students at the Faculty of Education for Pure Sciences/ Ibn Al-Haytham for the academic year (2021-2022). The differences in their level of skills according to the gender variable (males and females) and the academic stages (first- second - third - fourth). The descriptive approach was adopted because it corresponds to the nature of the research objectives. The research sample consisted of (400 )students selected in a relatively random stratified way. The researcher constructed a logical reasoning test, which includes (6) sub-skills , which is (proportional - probabilistic- synthetic- deductive- logic- variable adjustment). The psych
... Show MoreInterest in the teaching profession is one of the most important steps on the road to education reform to develop the quality of education is not only through the teacher's professional competencies required, interest in the teaching profession in any society stems from fingerprints left by the teacher on his behavior and morals and their minds and their personalities. Today we are going to provide scientific, technical and research is enormous, we need more powerful skills and ways of thinking that must be acquired by the teacher. The current search is gaining importance in terms of:
- This is the first of its kind on the researcher's knowledge _ which deals with the modern trends in t
Abstract
This paper follows the growing interest and continuity of Islamic finance products worldwide, which has encouraged the formulation of financial institutions based on the concepts of Islamic Sharia in many countries of the world and is no longer limited to Islamic countries only, and Not exclusive to Muslims which is due to Islamic finance services and their ability to apply in non-Islamic societies, and perhaps what encouraged the development and progress of this industry Islamic history, which was attended by many different models With the development of trade's share between different countries as well as trips carried out by Muslims
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