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.
Contemporary life is racing against time in its temptations and variables, and it has become shaped and changed in an amazing way in its various aspects and fields. This was facilitated by intellectual and scientific communication between civilizations, and the rapid progression in successive inventions and discoveries in the fields of science and arts of knowledge. This contributed to a great economic and commercial renaissance. Then, these economic developments entered the world into a very strong competition, which forced producers to calculate all production costs, to reach the highest profits by reducing the price of the produced commodity on the one hand, and achieving quality in appearance (especially) on the other hand. Since the ma
... Show MoreBackground: In the past, an association between Tuberculosis (TB) and Diabetes Mellitus (DM) was widely accepted, today the potential public health and clinical importance of this relationship seems to be largely ignored. The national clinical and policy guidance in the UK on the central of TB, for example, does not consider the relationship with DM.Objectives: To determine the risk of association between diabetes mellitus and pulmonary TB.Methods: A retrospective study conducted in Ibn Zuhr hospital for chest diseases from Jan 2008 – sep 2010 , included in the study 402 patients with TB divided into diabetic & non diabetic, 96 (23.8%) were diabetic while other 306 were TB not diabetic.Results: Risk of TB among DM patients were cle
... Show MoreAn intuitionistic fuzzy set was exhibited by Atanassov in 1986 as a generalization of the fuzzy set. So, we introduce cubic intuitionistic structures on a KU-semigroup as a generalization of the fuzzy set of a KU-semigroup. A cubic intuitionistic k-ideal and some related properties are introduced. Also, a few characterizations of a cubic intuitionistic k-ideal are discussed and new cubic intuitionistic fuzzy sets in a KU-semigroup are defined.
Four different spectrophotometric methods are used in this study for the determination of Sulfamethoxazole and sulfanilamide drugs in pharmaceutical compounds, synthetic samples, and in their pure forms. The work comprises four chapters which are shown in the following: Chapter One: Includes a brief for Ultraviolet-Visible (UV-VIS) Absorption spectroscopy, antibacterial drugs and sulfonamides with some methods for their determination. The chapter lists two methods for optimization; univariate method and multivariate method. The later includes different types, two of these were mentioned; simplex method and design of experiment method. Chapter Two: Includes reaction of the two studied drugs with sodium nitrite and hydrochloric acid for diazo
... Show MoreNeurolinguistics is a new science, which studies the close relationship between language and neuroscience, and this new interdisciplinary field confirms the functional integration between language and the nervous system, that is, the movement of linguistic information in the brain in receiving, acquiring and producing to achieve linguistic communication; Because language is in fact a mental process that takes place only through the nervous system, and this research shows the benefit of each of these two fields to the other, and this science includes important topics, including: language acquisition, the linguistic abilities of the two hemispheres of the brain, the linguistic responsibility of the brain centers, and the time limit for langua
... Show MoreThis study aims to focus on the Motives behind volunteer work among a sample of volunteers working in civil society organizations and check if there are statistical differences with those variables according to (gender, age, job, period of volunteer work, and residence. The sample consists of (220 )volunteers,(189) male and(31) female from southern, northern and central governorate .The Volunteer Functions Inventory(VFI)(Clary & et al,1989)was applied, It consisting of(30) items with six fields( Values, Understanding, Social motives, Career, Protective, Enhancement).
The results show that the most common and important motivations are (Values, Understanding, and social motivations), there are differenc
... Show MoreThis is an empirical investigation of the tribal power in Iraq and its consequences on the socio-political system. A theoretical background concerning thestate kinship, tribe and tribal involvement in politics has been displayed with example of tribal power over people within the social context. Socio-anthropological method of data collection has been used, including a semi-structured interview with a sample of 120 correspondents. The outcome revealed that the feeble and corrupted state (government) play a vital role in encouraging the tribe to be dominant. The people of Iraq are clinging to the tribe regardless of whether they believe in it or not. Although they are aware that the tribe is a pre-state organisation and marred shape of ci
... 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
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