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 presence of alkaloids in Crassula ovata is a topic that is still unexplored, as there are no published studies on the matter. This study demonstrates the presence of an alkaloid compound (and its class) for the first time in Crassula ovata. The plant material was defatted with n-hexane, and a Soxhlet apparatus was used for the extraction process, while the acid-base method was used for the isolation of alkaloids from the chloroform fractions. The quaternary alkaloid was precipitated from the aqueous layer spontaneously, in high quantity. By using standard spectroscopic methods (including liquid chromatography - mass spectroscopy) we were able to clarify the structure of the precipi¬tated compound as a tetrahydroprotoberberine a
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Every cultural achievement is a creative text, and every text is a group of signs. The Winged Bull sculpture is a sort of text that is not confined to some signs; indeed, its cultural signs go far beyond as they are open-ended, everlasting and it lends itself to various horizons of interpretation. The recipient has to combine the signs of this sculpture, which belong to different patterns, in the pursuit for perfection so that he can decode its media message.
I have tackled this sculpture by adopting a semiotic approach. The semiotic approach is a modern critical approach which is as wide as culture and as rich as knowledge. It has been linked to modernism, which in turn has been linked to modern critical approaches, because it can
Verrucae vulgares are commonly encountered. The present work is designed in an attempt to build a systematic procedure for treating warts by carbon dioxide laser regarding dose parameters, application parameters and laser safety.
Patients and Methods: The study done in the department of dermatology in Al-Najaf Teaching Hospital in Najaf, Iraq. Forty-two patients completed the study and follow up period for 3 months. Recalcitrant and extensive warts were selected to enter the study. Carbon dioxide laser in a continuous mode, in non-contact application, with 1 mm spot size was used. The patients were divided into two groups. The first group of patients consisted of 60 lesions divided to 6 equal groups, in whom we use different outputs a
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A low-cost, RGB LED-based visible-light spectrophotometer was designed to measure dyes concentration. Dyes are widely used as indicators or coloring agents in different applications and knowing their concentration is an essential part for many studies. The proposed spectrophotometer provides many functionalities that clones the traditional expensive spectrophotometers for a budged price under $50. It was aimed to provide a versatile tool for instructors and educators to teach their students the fundamental concepts behind spectrophotometry. Malachite green, methyl red, and methyl orange dyes were chosen to be good samples to show the integrity of the proposed spectrophotometer in terms of accuracy, repeatability, and sensitivity as
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Background: Piezosurgery improved the split approach by making it safer, easier, and less prone to complications when treating extremely atrophic crests. Densah drills, with their unique design, expand the ridge by densifying bone in a reverse, non-cutting mode. Objective: To assess the effectiveness of sagittal piezosurgery, which involves cutting bone to the full implant depth and then expanding it using osseodensification drills. We use this technique to expand narrow alveolar bones and simultaneously place dental implants in the maxillary and mandibular arches. Methods: Fourteen patients received 31 dental implants. The maxillary arch received 19, and the mandible received 12 dental implants. This study will include patients who
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