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.
In this study, we introduce new a nanocomposite of functionalize graphene oxide FGO and functionalize multi wall carbon nanotube (F-MWCNT-FGO).The formation of nanocomposite was confirmed by FT-IR ,XRD and SEM. The magnitude of the dielectric permittivity of the (F-MWCNT-FGO) nanocomposite appears to be very high in the low frequency range and show a unique negative permittivity at frequencies range from 400 Hz to 4000Hz. The ac conductivity of nanocomposite reaches 23.8 S.m-1 at 100Hz.
In this research, a factorial experiment (4*4) was studied, applied in a completely random block design, with a size of observations, where the design of experiments is used to study the effect of transactions on experimental units and thus obtain data representing experiment observations that The difference in the application of these transactions under different environmental and experimental conditions It causes noise that affects the observation value and thus an increase in the mean square error of the experiment, and to reduce this noise, multiple wavelet reduction was used as a filter for the observations by suggesting an improved threshold that takes into account the different transformation levels based on the logarithm of the b
... Show MoreThe study included gross morphology and pollen of plants – which collected during field trips , and dry ones for most specimen preserved with the Iraqi herbaria – related to the genus Lycopus L. , and to identify the unidentified species and rectify the error there in , so according to that the species L. europaeus L. only were specified for the genus . Through this work the varity L. europaeus var. glabrescens Schmidely were found at the first time , and suggested to record anew for Iraq . Pollen were of medium size, and had an ellipsoid shape in the equatorial view , and hexagonal in the polar view. The ecological and soil quality where these genus plants grows were specified , and were geographically distribut
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Background: Lymphomas are group of diseases caused by malignant lymphocytes that accumulate in lymph nodes and caused the characteristics lymphadenopathy. Occasionally, they may spill over into blood or infiltrate organs outside the lymphoid tissue. The major subdivision of lymphomas is into Hodgkin lymphoma and non–Hodgkin lymphoma and this is based on the histologic presence of Reed-Sternberg cells in Hodgkin lymphoma. Salivary immunoglobulin A is the prominent immunoglobulin and is considered to be the main specific defense mechanism in oral cavity. The aim of this study was to determine the level of salivary immunoglobulin A in lymphoma patients before and after chemotherapy treatment. Subjects, materials and methods: The study i
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Introduction: Dental fear is defined as the patient’s specific reaction towards stress related to dental treatment in which the stimulus is unkn..
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Abstract
Among the things that have happened and that have emerged from the developments in society is the phenomenon of dairy banks, where institutions collect milk from donating mothers or sellers of milk and benefit from it by sterilizing and selling it.
This topic is considered one of the important topics, as Islam considers breastfeeding as a link as well as parentage, and it has the same genealogy as the spread of sanctity. Therefore, Imamate jurists addressed this topic with research despite its absence in Islamic societies.
The importance of r
... Show MoreThis paper deals with the determination of stresses and deflections of clamped circular diaphragm strengthened by one or two ring-shaped concentric ribs, under uniform static and dynamic pressures. The simulation has been achieved by using the well-known engineering software finite element package MSC/NASTRAN.
As a design study, the effect of using a clamped ring, and the effect of using a ring-shaped rib on both surfaces of diaphragm instead of one, has been discussed in this work. To show the effectiveness of this study, results of this work have been compared with published data [1].
In the conclusion, the authors underline the validity of the&n
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