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.
This paper studies the demonstratives as deictic expressions in Standard Arabic and English by outlining their phonological, syntactic and semantic properties in the two languages. On the basis of the outcome of this outline, a contrastive study of the linguistic properties of this group of deictic expressions in the two languages is conducted next. The aim is to find out what generalizations could be made from the results of this contrastive study.
The occurrences of invasive candidiasis has increased over the previous few decades. Although Candida albicans considers as one of the most common species of organisms, that cause acquired fungal infections. Candida albicans is an opportunistic fungal pathogen and inherent in as a lifelong, the yeast is present in healthy individuals as a commensal, and can reside harmlessly in human body. However, in immuno-compromised individuals, the fungus can invade tissues, producing superficial infections and, in severe cases, life-threatening systemic infections. This review wills emphasis on virulence factor of C. albicans including (adhesion, invasion, candida proteinase, and phenotypic switching and biofilm formation. I
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A study of the hadiths of supplication orchestration
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Construction projects are characterized as projects with multi phases and activities, complex, unique, and have many different parties and stakeholders. Risks could appear at one or more of the construction project stages and may affect the achievement of project objectives. Therefore, one of the key elements in the planning phase of any project is the risk management process (RMP). This study attempts to understand the terminology of risk in general, risk management, and response to risk in particular. This study is mainly a review of thirty-eight studies that have been published between 1997 and 2020 that demonstrate the importance of the crucial phase of risk response from the risk management process and its impact on
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The seizure epilepsy is risky because it happens randomly and leads to death in some cases. The standard epileptic seizures monitoring system involves video/EEG (electro-encephalography), which bothers the patient, as EEG electrodes are attached to the patient’s head.
Seriously, helping or alerting the patient before the seizure is one of the issue that attracts the researchers and designers attention. So that there are spectrums of portable seizure detection systems available in markets which are based on non-EEG signal.
The aim of this article is to provide a literature survey for the latest articles that cover many issues in the field of designing portable real-time seizure detection that includes the use of multiple
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Background: Lung cancer is responsible for the most
cancer deaths in both men and women throughout the
world. Deaths from lung cancer (160,440 in 2004,
according to the National Cancer Institute) exceed the
number of deaths from four other major cancers combined
(breast, colon, pancreatic and prostate).
Objective: To assess the behavior and the approaches of
lung cancer in a sample of Iraqi patients.
Methods: This descriptive retrospective study was
performed using the records of 390 patients proved to have
lung cancer that had attending the Thoracic Surgery
Department of Surgical Specialties Hospital-Medical City
\Baghdad for the period from January, 1st
, 2001 to
December, 31st
,2002.
Res