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.
Morphologies of ceramic hollow fiber membranes prepared by a combined phase-inversion and sintering method were studied. The organic binder spinning solution containing suspended Al₂O₃ powders was spun to a hollow fiber precursor, which was then sintered at elevated temperatures( 300 ˚C, 1400 ˚C, 25 ˚C) in order to obtain the Al₂O₃ hollow fiber membranes. The spinning solution consisted of polyether sulfone (PES), N-methyl-2-pyrrolidone (NMP), which were used as polymer binder, solvent, respectively. The prepared Al₂O₃ hollow fiber membranes were characterized by a scanning electron microscope (SEM). It is believed that finger-like void formation in asymmetric ceramic membranes is initiated by hydrodynamically unstable vis
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Drought is a natural phenomenon in many arid, semi-arid, or wet regions. This showed that no region worldwide is excluded from the occurrence of drought. Extreme droughts were caused by global weather warming and climate change. Therefore, it is essential to review the studies conducted on drought to use the recommendations made by the researchers on drought. The drought was classified into meteorological, agricultural, hydrological, and economic-social. In addition, researchers described the severity of the drought by using various indices which required different input data. The indices used by various researchers were the Joint Deficit Index (JDI), Effective Drought Index (EDI), Streamflow Drought Index (SDI), Sta
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In this research, nanofibers have been prepared by using an electrospinning method. Three types of polymer (PVA, VC, PMMA) have been used with different concentration. The applied voltage and the gap length were changed. It was observed that VC is the best polymer than the other types of polymers.
Lifestyle Medicine is the application of evidence-based lifestyle approaches for the prevention, treatment, and even the reversal of lifestyle-related chronic diseases such as diabetes, hypertension, heart disease, obesity, polycystic ovarian diseases, dementia, arthritis, and cancers
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The loss of dental hard tissue as a result of odontoclastic activity is known as root resorption. It is unwanted and pathological in permanent teeth. Root resorption may happen within the root canal called internal root resorption or on the outer surface of the root called external root resorption. Regardless of where it occurs, root resorption is irreparable, can cause pain for the patient, necessitates treatment, and in some circumstances, resulting in the early loss of the affected tooth. It might be challenging to precisely diagnose and treat root resorption. There is limited information within literatures on root resorption therefore this review aims to understand the radiological and clinical characteristics of r
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