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
This study aims to identify the degree to which the first cycle teachers use different feedback patterns in the e-learning system in addition to the differences in the degree of use according to specialization, teaching experience, and in-service training in the field of classroom assessment, as well as the interaction between them. The study sample consisted of (350) female teachers of the first cycle in government schools in Muscat Governorate for the academic year 2020/2021. The study used a questionnaire that contained four different patterns of feedback, which are reinforcement, informative, corrective, and interpretive feedback. The psychometric properties of the que
... Show MoreThe aqueous extract of Citrullius colocynthis dried seeds (160 ?g/ml) was in vitro evaluated for its effect on phagocytic index (PI) and lymphocyte transformation index (LTI) of blood cells obtained from 30 apparently healthy blood donors (15 males and 15 females). The PI was further in vivo evaluated in cells of peritone, spleen and liver of mice treated with the extract at a dose of 0.64 mg/kg. The results revealed that in in vitro study, phagocytic cells treated with the extract showed a significant increased percentage as compared with untreated cells (60.0 vs. 44.1%). Phagocytes obtained from peritone (44.1 vs. 30.0%) and spleen (45.6 vs. 39.6 %) of treated and untreated mice behaved in a similar manner, while liver phagocytes showed n
... Show MoreA study carried out to prepare Hg1-xCdxTe compound and to see the effect on increasing the percentage of x on the compound structure by using x-ray diffraction and atomic absorption for 0
the history of the Scouting movement reflects the global social cultural and technological change over more than a century. scouting aims to develop young people worldwide through educational programs based on specific principles and values. in arab countries, the scouting movement is considered one of the most important platforms contributing to developing young people and enhancing their rule. positive in society, began with the establishment of the first Scout camp in the region and witnessed great growth and prosperity over the decades the research reveals the historical roots and development of the scout movement in the leading arab countries and analyzes the positive impact of scout movement in the leading arab countries on the develo
... Show MoreThe varied thermal conductivity (insulation) of silica aerogel with heating for different pH has been investigated, it has been depended on ambient pressure drying method in the preparing silica aerogel samples, also six different pH of samples (1, 2, 3, 7, 8 and 9) were treated under five degree of heating with (50,100,150,200 and 250) ᴼC. This technique is important to test the carry-outs hydrophobic silica to temperature without high-quality material changes in the basic characteristics. The hot-wire technique is used in this work to examine the thermal conductivity, Fourier Transform Infrared Spectroscopy (FTIR) depended to characterize the bonds and their artificial by heating. Resu
... Show MoreThis study aimed to detect of contamination of milk and local soft cheese with Staphylococcus aureus and their enterotoxins with attempt to detect the enterotoxin genes in some isolates of this bacteria. A total of 120 samples, 76 of raw milk and 44 of soft cheese were collected from different markets of Baghdad city. Enterotoxins in these samples were detected by VIDAS Set 2 system and it was found that enterotoxin A is present in a rate of 44.74% in milk samples and in a rate 54.50% in cheese samples. While other enterotoxins B, C, D, E were not found in any rate in any samples.
Through the study 60 isolates obtained from milk and cheeses were identified as Staphylococcus aureus by cultural, morphological and biochemical test by u
Intellectual property rights of all kinds، and their nature، are considered a tool in the hands of their owner that enables him to monopolize the benefits that you confer on them without any dispute or mediation from anyone. Intellectual property on its intellectual product، and preventing others from exploiting it without obtaining the permission of its owner All of this is reflected positively on the progress of the industrial and commercial field، and this justifies the protection provided by the laws regulating intellectual property rights to its owner، whether at the national or international level، and with our recognition of the right of the owner of intellectual property rights to enjoy the exclusive use of his right، and
... Show MoreThe regression analysis process is used to study and predicate the surface response by using the design of experiment (DOE) as well as roughness calculation through developing a mathematical model. In this study; response surface methodology and the particular solution technique are used. Design of experiment used a series of the structured statistical analytic approach to investigate the relationship between some parameters and their responses. Surface roughness is one of the important parameters which play an important role. Also, its found that the cutting speed can result in small effects on surface roughness. This work is focusing on all considerations to make interaction between the parameters (position of influenc
... Show MoreAfrican-American writers during the 19th century wrote in the shadow of the prominent romance, sentimental, and domestic fiction. Harriet Wilson’s Our Nig (1859) reflects an “alternative social character”, for the female protagonist suffers racism in the free North, because she is a mulatto child. Through depicting the life of free blacks, who supposedly lives a better life than Southern slaves, Wilson exposes how she has actually lived and sensed life in antebellum America. According to Raymond Williams (2011), there are two kinds of literary writings. The first represents the general tendency of the age, and he calls it “dominant social character”; representing the majority content of both the public writing and speaking. But, a
... Show MoreThis study investigates the treatment of used lubricating oils from AL-Mussaib Gas Power Station Company-Iraq, which was treated with different extractive solvents (heptane and 2-propanol). The performance activity of these solvents in the extraction process was examined and evaluated experimentally. Operating parameters were solvent to oil ratios of (1:2, 1:4, 1:6, and 1:8), mixing time (20, 35, 50, and 65 min), temperatures (30, 40, 50, and 60 ºC), and mixing speed (500 rpm). These parameters were studied and analyzed. The quality is determined by the measuring and assessment of important characteristics specially viscosity, viscosity index, specific gravity, pour point, flash point, and ash content. The results confirm that the
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