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.
DBNRAAK Mohammed, International Journal of Research in Social Sciences and Humanities, 2020
Despite the principle of separation of powers brought by the French Revolution, which entrusted the task of drafting legislation and its amendment to the legislative authority and the task of settling disputes and settling them in the judiciary. However, since that date, the French judiciary has played a major role in the development of French civil law (In spite of all the economic and social developments that have taken place in French society throughout these years) since its promulgation until February of 2016, the date of the Legislative Decree No. 131 of the year 2016 A modification is the largest in the history of the French Civil Code (which was the judicial precedents in which a significant impact), was assisted by the French judic
... Show MoreIn this study, a predicated formula is been proposed to find the shear strength of non-prismatic beams with or without openings. It depends on the contributions of concrete shear strength considering the beam depth variation and existing openings, shear steel reinforcements and defines the critical shear section, the effect of diagonal shear reinforcement, the effect of inclined tensile steel reinforcement, and the compression chord influence. The verification of the proposed formula has been conducted on the experimental test results of 26 non-prismatic beams with or without openings at the same loading conditions. The results reflect that the predicted formula finds the shear capacity of non-prismatic beams with openings, it is co
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The general crisis of research methods in the social sciences
Research methodology: philosophy and techniques, founded by philosophers and applied by scientists, and no accurate application of techniques except with a deep understanding of philosophy, as a prerequisite. This fact is almost completely absent from the Iraqi and Arab academic mentality. This constituted one of the dimensions of the double crisis - theoretical and applied - of research methods in the social sciences. As first, there is no philosophy of science, neither as an independent material nor as an introductory subject, but not even an oral confirmation. Secondly, the advancement of quantitative research methods are presented without a background philosophy, as sol
The cyanobacterial neurotoxin
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Although war of waters has existed throughout history, it has gained increasing relevance in recent decades, particularly in regions where transboundary rivers are politically contested. One of the most critical and ongoing disputes is between Iraq and Turkey over the control on the Tigris and Euphrates rivers. The study seeks to achieve three primary objectives: investigating the types of transitivity processes most frequently used in the politicians' utterances; analysing how the positive self-representation and negative other-representation are uncovered in the politicians' utterances; and exploring the similarities and differences in these linguistic tools between the two opposing sides. To achieve these objectives, the research
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Background: Fiber-optic endoscopy is an important
investigation of the large intestine, whether or not the
radiologist (barium enema) has discovered a lesion in
the bowel. Colonoscopy affords a unique opportunity
to direct visualization of entire colonic mucosa. At
the same time, the physician can obtain biopsy specimens, remove polyps, and decompress volvuli.
Most experienced endoscopists and well prepared
patients can reach the cecum in over 90% of patients.
If colonoscopy is properly performed, it has a low
risk of complications, such as perforation and bleeding.
Methods: A total of 70 consecutive patients admitted
to Endoscopy department at Al-Kindy Teaching hospital from September- 2008 to July-2009.
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