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.
In the Name of God, the Most Gracious, the Most Merciful
Praise be to God, who taught the pen anthropology unless he knows, and peace and blessings be upon the master of bullying, and the imam of the eloquent Prophet Muhammad, the sincere and faithful, and his family and companions as a whole and whoever followed him to the Day of Judgment. And after:
The science of grammar is among the most important of all language sciences at all, if not the most important of its sciences, due to the multiplicity of its doctrines and schools, the diversity of its methods, its phenomena and subjects, as well as the connection of this science with the most honorable languages,
Employing the social personalities (celebrities) in all fields (artistic, sports, media, etc.) is an important media and visual communication means of identification for the companies and institutions in order to convey the advertising idea in accordance with the creative, aesthetic and functional principles aimed at promoting products and gaining the symbolic value for the company. This study investigates the employment of social personalities in the commercial advertising design in order to pinpoint the importance of employing celebrities and their representation in the advertisement to convey the meaning that signifies the advertisement goal. Thus the question of the study is: "What are the mechanisms of employing celebrities in the d
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The Organizational Transparency is regarded one of the effective means in the attempts of the restoration and working to prevent the corruption and reduce the negative managerial economic social and political effects.
Accordingly, this study aims at importance of performing an explorative analytical study in order to stand on the effect of the Organizational Transparency in the reduction of environment of Iraqi Organizations.
To achieve this study, three hypotheses were chosen; the first is the correlation relation and the second is the effect and the third is the differences, and statistical means represented by correlation coefficient "Spearman", "", "Mann- Whit
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The advertisement is important in maximizing the resources of journalistic institutions. It helps them to perform their duties and also establishes their independence. However, this type of communication has often overlapped with other types of communication, including media and publicity.
Those in charge of the press bear responsibility in this regard, as some of them harness the advertisement for personal purposes; or detrimental to media content. Many communication authorities have drawn attention to the danger of confusing the concepts and levels of the three activities and have moved towards establishing rules to reduce overlap between them.
The aim of this research is to try to disengage the concept of advertising,
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This study aims to develop a thermosensitive mucoadhesive periodontal in situ gel of secnidazole for local release of drug for treatment of periodontitis, in order to increase the drug residence time and to increase patient compliance while lowering the side effects of the drug.
Cold method was used to prepare 30 formulas of secnidazole periodontal in situ gel, using different concentrations of thermosensitive polymers (poloxamer407 alone or in combination with poloxamer 188) and methyl cellulose (MC ) or hydroxypropyl methylcellulose (HPMC K4M )in different concentrations used as mucoadhesive polymer and the resultant formulations were subjected to several tests such as gelation temperature GT, appearance and pH value. The fo
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Heritage is considered as the civilization and cultural wealth accumulated over the . centuries, whereas architectural heritage is the physical witness of that civilization. Despite the fact that architectural heritage is the most important effort for economic development of any communit,، it suffers from deterioration and neglection especially in the Arab communities. Recently awareness has increased about the importance of investing on architectural heritage generally and sustainable investment particularly. The goal of investment process in heritage areas is to revive economic activity in addition to attempt to revive the heritage and community values. Research aims to examine the relationship between sustainable investment and
... Show MoreBackground: A core set of checks have been incorporated into World Health Organization (WHO) WHO surgical safety checklist. Lack of access to basic surgical care remains a major concern in low-income settings.
Objective: We use a WHO surgical safety checklist items to improve team communication and cooperation to help in reduction of morbidity and mortality of surgical procedures.
Methods: This is a prospective study involving 300 patients after applying the 19 items of the surgical safety checklist with different types of operations had been operated in the surgical theater at Al-Kindy Teaching Hospital during the period 1st of September 2016
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Abstract:
In light of globalization and internationalization of financial markets, issues arising from financial crises have become increasingly serious and fundamental, creating a lot of debate among experts around the world. So, many studies have attempted to investigate what measures can be taken to detect and prevent crises before they devastate the economies.
Therefore, this paper examines the Effectiveness of the Monetary Policy (MP) to Avoid, Reduce or Treat the Financial Crisis in Malaysia. Scholars have yet to agree on the issue
... Show MoreFire is the most sever environmental condition affecting on concrete structures, thus investigating for fire safet, IJSR, Call for Papers, Online Journal
Praise be to God who has guided us, and we would not have been guided had it not been for the guidance of God Almighty. The life of the Commander of the Faithful, Imam Ali bin Abi Talib, peace be upon him, represented the highest meanings of sacrifice, redemption, courage, heroism, patience, altruism, and truth, which were embodied in his unique personality, whose counterpart is rare, if not unparalleled in history. Except for the person of the Holy Prophet Muhammad (may God bless him and his family and grant them peace). In this research, we have presented pictures from the life of Imam Ali bin Abi Talib (peace be upon him), as we have clarified his life, upbringing, conversion to Islam and his ma
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