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.
A study that collected 240 samples and divided into two groups: the first 120 samples were for diabetics and the second 120 samples were for healthy people, and each group included (90, 20.10) samples from the mouth, urine and vagina respectively, The results showed positive (28.67, 4.00, 1.67) isolates of Candida. In the mouth, urine and vagina, respectively, of diabetic patients compared to (9.33, 2.33, 5.00) positive isolates in the mouth, urine and vagina, respectively, in the healthy. The rate of positive isolates in women was high in women with diabetes and healthy, and it reached 25.33 and 9.00 isolates, respectively, compared with the rate of isolates in men with Candida disease for diabetic patients and healthy people 14.67 and 2.0
... Show MoreReceipt date:3/13/2021 accepted date:5/26/2021 Publication date:12/31/2021
This work is licensed under a Creative Commons Attribution 4.0 International License.
energy is one of the strategic resources within international politics, and this is through the existing competition between the international powers on it, and the global powers have begun to rely on interest in new areas, such as import, depending on new projects an
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The idea of the design of combination Between split – plot and split block means that an experiment conducted with a design
formed by combination Between split – plot and split block, and it presents a precise manner to analytic who aimed to make appropriate statistical analysis for the experiment because such design contains four random errors , it make a high precision rather than another designs. The plan and the theoretical analysis were presented with application to show its idia and the ability to use it in many fields especially in agricultural experiments field .
The article reflects the results of the analysis of the use of metaphors as one of the main means used by Lyudmila Ulitskaya when writing the novel “Sincerely Yours Shurik” to form the image of the main hero in the novel. The main purpose of the article is to consider metaphors, which helped the author to form the image of the main character Shurik in the text space through the stages of his life path, closely related to the people around him, who is always happy to be useful (hence the title "Sincerely Yours"), among which the female images of his relatives, girlfriends and others stand out as a special layer in the narrative. And in the course of the study, the following tasks were solved: the metaphors that make up the image of the
... Show MoreThis research aims to identify the impact of Daniel's model on the development of critical thinking. In order to achieve this objective, the following hypotheses are formulated: 1. There is no statistically significant difference at the significance level (0.05) between the average differences in the posttest scores of the experimental group taught according to Daniel's model and the control group taught according to the traditional method in the measure of critical thinking. 2. There is no statistically significant difference at the significance level (0.05) between the average differences in the preand post-tests scores of the experimental group taught according to Daniel's model in the measure of critical thinking. The current research i
... Show MoreCompounds were prepared from In2O3 doped SnO2 with different doping ratio by mixing and sintering at 1000oC. Pulsed Laser Deposition PLD was used to deposit thin films of different doping ratio In2O3: SnO2 (0, 1, 3, 5, 7 and 9 % wt.) on glass and p-type wafer Si(111) substrates at ambient temperature under vacuum of 10-3 bar thickness of ~100nm. X-ray diffraction and atomic force microscopy were used to examine the structural type, grain size and morphology of the prepared thin films. The results show the structures of thin films was also polycrystalline, and the predominate peaks are identical with standard cards ITO. On the other side the prepared thin films declared a reduction of degree of crystallinity with the increase of doping ra
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The research aims to explain the References of receiving the explicit and implicit knowledge mentioned in the Noble Qur'an. The two researchers adopted the documentary and inductive approach to study the topic. Among the conclusions of the research: The Noble Qur'an dealt with many terms and concepts that refer to the References of making explicit knowledge available, including books, which were represented by the divine books (the Qur'an, the Torah, the Zabur and the Gospel) and their concepts (the book, the Qur'an, the guidance, the remembrance, the revelation, the light, the newspapers, the plates). He dealt with many concepts that refer to the References of providing tacit knowledge, which was represented by the communication between tw
... Show More Thsst researcher problem of delays faced by researchers are all waiting to evaluate their standards by the experts who must take their views to extract the truth Virtual important step first step in building standards whatsoever, then the difference of opinion among experts about the paragraphs Whatever the scope of their functions, leading to confusion in maintaining these paragraphs or delete? Or ignore the views and opinion of the researcher to maintain the same? Or as agreed upon with the supervisor if he was a student? Especially if the concepts of a modern new building.
Therefore, the researcher sought to try to find a solution to her problem to conduct an experiment to test building steps
Background: Health information systems in most countries are inadequate in providing the needed management support and the current health information systems are therefore widely seen as management obstacles rather than as tools,Objectives: the current study is an attempt to assess the behavioral and organizational determinants of health information system performance in Iraq.Methods: A cross-sectional study was conducted by interviewed a total of 189 respondents selected from six Iraqi governorates. The Organizational and Behavioral Assessment Tool was used to measure the behavioral and organizational determinants of health information system performance, it is one of the PRISM package tools that are used to assess the health informatio
... Show MoreHeritage reflects peoples' memory and essence of nations. Thus, this divan was really the material and tool for writers in general and poets in specific both in their artificial innovations . Accordingly, modern writers have endeavored to bring heritage back in all its details and occurrences. Abdullwahab Al-Bayati's experience had reflected his innovative and strong link with the humanitarian heritage, in that heritage in view of Al-Bayati means both the humanitarian expertise and gains that are able to extend from past to future passing through the present.From this, the poet had not disconnected his strong link with the Arab poetic heritage .Thus, the poet had utilized the Arab poetic heritage in expressing on the Arab contrary realit
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