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.
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This piece of research deals with assimilation as one of the phonological processes in the language. It is a trial to give more attention to this important process in English language with deep explanation to its counterpart in Arabic. in addition, this study sheds light on the points of similarities and differences concerning this process in the two languages. Assimilation in English means two sounds are involved, and one becomes more like the other.
The assimilating phoneme picks up one or more of the features of another nearby phoneme. The English phoneme /n/ has t
... Show Moreالنظام السياسي اليمني : دراسة في المتغيرات الداخلية
The aim of study is to shed light on an Islamic city which is unknown for a lot of people, it can have an old history in Parisian country and many events happen with it , This city is characterized with political, military, economic scientific ,and social features, This city is called Zanjan and it is one of the most important cities because it dates back to the period of post history and it has a good geographic location whereas it was, passage for trade caravans to pass through as well its land which was specialized in agriculture and industry. the study follows chronological order of historical events for the city, one of the most significant conclusions is to think that this city does belong to artifacts and it is an old city and it
... Show MoreBackground: Elastomeric chains are used to generate force in many orthodontic procedures, but this force decays over time, which could affect tooth movement. This study aimed to study the force degradation of elastomeric chains. Data and Sources: An electronic search on Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, LILACS, and PubMed was made, only articles written in English were included, up to January 2022.Study selection: Fifty original articles, systematic reviews, and RCTs were selected. Conclusion: Tooth movement, salivary enzymes, alcohol-containing mouthwash, whitening mouthwash, and alkaline and strong acidic (pH <5.4) solutions all have a significant impact on elastomeric chain force degradation. The fo
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Marriage is a holly secret in Christian religion .So it id natural that its ceremonies acquired religious form .In general the marriage is contracted by minister of religion in presence of the two parties or by a proxy or presence of parents if it is necessary . And to make the condition of publicity for the marriage ,its procedures must be made before witnesses .Also the minister of religionhave to confirm the agreement of the two parties before beginning the procedures.The marriage ceremonies are made.These procedures are religious traditions that includes praying and make blessings and putting the rings in fingers by thepriest . The marriage is a holly secret performed by the crown pray according to the church religious traditions
Aniera desert/cola was found new to science and to the Iraqi fauna. The description was
mainly based on external features and male genit