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.
KE Sharquie, MM Al-Waiz, AA Al-Nuaimy, Saudi medical journal, 2002 - Cited by 11
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The Iraqi government seeks to overcome the financial crisis by investing and privatizing some projects to achieve sustainable growth. Most of the investment projects in Iraq suffer from many constraints that greatly impact the success of these projects. A survey of the opinions of a group of experts was conducted to identify the most important constraints facing the investment process in Iraq. Then the experts' answers were arranged in a closed questionnaire and distributed to the research sample for which the statistical analysis was conducted. Through it, the most important (17) factors that had the greatest impact on the failure of investment projects in Iraq were reached. One of the main constraints was
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A stylistic study in the poetry of Hafiz Ibrahim, praise be to God, Lord of the worlds, and prayers and peace be upon his best messengers, and the seal of his prophets, Muhammad and his good and pure family, and after ...
The poet Hafez Ibrahim is considered one of the well-known poets in the modern era, and his language was distinguished by sobriety, eloquence in expressions, and beautiful meanings And he had my journey in the study of his poetry a stylistic study, and the research came with an introduction in which the concept of stylistics was briefly explained, since it was studied by many researchers, then divided the research into three topics: I studied in the first the construction of the poem, and I stood at the most importan
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The right to property is one of the most fundamental rights enjoyed by individuals, and most national constitutions and laws, as well as international conventions, have to be respected and protected only in accordance with the economic and social development of the country (the so-called public benefit) and in return for just compensation. What is fair compensation?
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The term "nano gold," also known as "gold nanoparticles," is commonly used. These particles are extremely small, with a diameter of less than 100 nm, which is only a fraction of the width of a human hair. Due to their tiny size, nano gold particles are often found in a colloidal solution, where they are suspended in a liquid stabilizer. This colloidal gold is essentially another name for nano gold. The main method for producing gold nanoparticles in a colloidal solution is the citrate synthesis technique, which involves combining different solutions to precipitate the gold nanoparticles. In biological systems, copper complexes play a significant role at the active sites of many metalloproteins. These complexes have potential applications in
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The present study reports Morchella conica Pers.1818, which belongs to the family, Morchellaceae as a new record of Iraqi macromycota based on the morphological and molecular methods. During their short and often sporadic fruiting season, this fungal species was found in mixed forest unburned areas in Branan ranges (Suliamaniya Province, Northeast Iraq). Currently, M. conica is the second Morchella species reported from Iraq. The current study aimed to introduce this new record, which is poorly studied in the Middle East. M. conica is morphologically described and phylogenetically confirmed. The relationship between this species and other species within the genus was studied using the nrDNA ITS sequences from different species and divers
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