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.
The concept of Assemblage appeared obviously in Postdramatic works, where a character or a text may stand as an assemblage of potentialities in the sense that it signifies unidentified subjectivity. Assemblages are constituted essentially of heterogeneous elements yet fused without specific demarcations. In order to enjoy the desired productivity at a "smooth pace," the regularities of political and societal institutionalization are disseminated. To achieve this dissemination, Deleuze-Guattari suggest an unsatiated platform of a "Body without Organs' (BwO), where desire escapes identification. Martin Crimp (b. 1956) defines his off-stage characters in Attempts on Her Life (1997), Anne, or whatever the name is, as a 'BwO', upon which
... Show MoreThe present work describes guggul as a novel carrier for some anti-inflammatory drugs. Guggulusomes containing different concentration of guggul with aceclofenac were prepared by sonication method and characterized for vesicle shape, size, size-distribution, pH, viscosity, spread ability, homogeneity, and accelerated stability in-vitro drug permeation through mouse skin. The vesicles exhibited an entrapment efficiency of 93.2 ± 12%, vesicle size of 0.769 ± 3μm and a zeta potential of - 6.21mV. In vitro drug release was analyzed using Franz’s diffusion cells. The cumulative release of the guggulusomes gel (G2) was 75.8% in 18 hrs, which is greater than that all the gel formulation. The stability profile of prepare
... Show MoreThe study aims to build a water quality index that fits the Iraqi aquatic systems and reflects the environmental reality of Iraqi water. The developed Iraqi Water Quality Index (IQWQI) includes physical and chemical components. To build the IQWQI, Delphi method was used to communicate with local and global experts in water quality indices for their opinion regarding the best and most important parameter we can use in building the index and the established weight of each parameter. From the data obtained in this study, 70% were used for building the model and 30% for evaluating the model. Multiple scenarios were applied to the model inputs to study the effects of increasing parameters. The model was built 4 by 4 until it reached 17 parame
... Show MoreAbstract: Residual ridge resorption is chronic, progressive, irreversible and cumulative condition associated with teeth loss. Management of a residual ridge with severe resorption to fulfill the patient’s esthetic and functional requirements is quite difficult for the practitioner and also in the construction of an acceptable appliance. As the height of the edentulous ridge reduces the mandibular denture will be improperly function. Severe resorption of the mandibular alveolar ridge may cause instability and discomfort of the convention acrylic resin denture. Dealing with this condition requires clinical skills and knowledge. Treating the severely resorbed mandibular ridge is a challenging effort for prosthodontics. This research present
... Show Morethe pursue of social systems history present to us solid evidence that the collapse of that systems be caused by either the stagnancy aftermath maturity or unreal intellectual foundation which lead to sudden collapse, while the capitalism can avoided that intellectual damages due to its dynamic system with appropriate auto adaptation mechanism and use it excellently in the right time.
The globalization had excrete (as one of the capitalism adaptation mechanism) its own targets and its methods in framework of multinationals corporations which consist with capitalism states that employed the international organizations to reconstruction the global economy to serve such targets. So the glob
... Show MoreHoneywords are fake passwords that serve as an accompaniment to the real password, which is called a “sugarword.” The honeyword system is an effective password cracking detection system designed to easily detect password cracking in order to improve the security of hashed passwords. For every user, the password file of the honeyword system will have one real hashed password accompanied by numerous fake hashed passwords. If an intruder steals the password file from the system and successfully cracks the passwords while attempting to log in to users’ accounts, the honeyword system will detect this attempt through the honeychecker. A honeychecker is an auxiliary server that distinguishes the real password from the fake passwords and t
... Show MoreThis study examines the structural performance of concrete-encased pultruded Glass Fiber Reinforced Polymer (GFRP) I-sections with shear connections. It specifically focuses on how different parameters affect the latter’s ductility, flexural strength, and load-carrying capacity. The key variables studied include various shear connector types, spacing, and geometries, as well as the compressive strength of concrete and the properties of GFRP. The finite element modeling and experimental validation show that the shear connectors significantly improve the ductility, ultimate capacity, and load transmission efficiency. The present review emphasizes that the shear connectors greatly enhance the structural performance when they are prop
... Show MoreThe moon tree, the lover of the night, cholera, the sea changes its colors are poetic products left by the pioneer of free poetry, as many have called her. She used to write poetry and publish it in magazines and newspapers until she published it with collections that came into existence from an early age. Several factors helped her in that that contributed to the formation of her personality and the maturity of her talent, including factors Family, including environmental, and psychological, until she later became the focus of attention of many, so she became taught in the universities of London, and students stood by her method of writing free poetry, this poetic color that Badr Shaker Al-Sayyab participated in pioneering. Whoever exam
... Show More