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 objective review is to inspect the involvement of Interleukin-6 (IL-6) in rheumatoid arthritis (RA) and to highlight the role of IL-6 and its variants in the pathogenesis of RA and response to anti-IL-6 agents. Several genetic and environmental risk factors and infectious agents contributed to the development of RA. Interleukin-6 is engaged in self-targeted immunity by modifying the equilibrium between T regulatory (T-reg) and T helper-17 (Th-17) cells. The evidences reported that IL-6 parti
model is derived, and the methodology is given in detail. The model is constructed depending on some measurement criteria, Akaike and Bayesian information criterion. For the new time series model, a new algorithm has been generated. The forecasting process, one and two steps ahead, is discussed in detail. Some exploratory data analysis is given in the beginning. The best model is selected based on some criteria; it is compared with some naïve models. The modified model is applied to a monthly chemical sales dataset (January 1992 to Dec 2019), where the dataset in this work has been downloaded from the United States of America census (www.census.gov). Ultimately, the forecasted sales
This study discusses the Critical Discourse Analysis of 2012 American Presidential Election Debate’. The researcher adopts a model proposed by Van Dijk’s (2006 d). Six ideological categories have been selected within the overall strategies of the ideological square are used. The categories are of three levels of discourse structure : (the meaning, the argumentation, and the rhetoric) .They have shown effective criteria for detecting the most disguised systems of racism and manipulation.
Based on the analysis, it can be concluded that the elite discourses of candidates contribute to the reproduction of domination, Orientalism, and Islamophobia. This can be appl
... Show MoreObjectives: This study aims to broaden our knowledge of the role of eDNA in bacterial biofilms and antibiotic-resistance gene transfer among isolates. Methods: Staphylococcus aureus, E. coli, and Pseudomonas aeruginosa were isolated from different non-repeated 170 specimens. The bacterial isolates were identified using morphological and molecular methods. Different concentrations of genomic DNA were tested for their potential role in biofilms formed by study isolates employing microtiter plate assay. Ciprofloxacin resistance was identified by detecting a mutation in gyrA and parC. Results: The biofilm intensity significantly decreased (P < 0.05) concerning S. aureus isolates and insignificantly (P > 0.05) concernin
... Show MorePeriodontitis is a persistent bacterial-causing disease which damages the supporting periodontium of the teeth. The complexity of supporting tissue structure makes the regeneration a challenge for periodontists. Early investigations were focused on discovering therapeutic substitutes that are biocompatible, simple to prepare and economic. This might cause a local release of growth factors that accelerate the healing process of the soft and hard tissue. Recently, platelet-rich fibrin (PRF) has received a wide attention as a biocompatible regenerative material in both dental and medical fields. PRF is a natural fibrin-derived biomaterial, and it is easy to obtain. It can be gotten from individual blood without the use of any external anticoag
... Show MoreIn this work, a numerical study is performed to predict the solution of two – dimensional, steady and laminar mixed convection flow over a square cylinder placed symmetrically in a vertical parallel plate. A finite difference method is employed to solve the governing differential equations, continuity, momentum, and energy equation balances. The solution is obtained for stream function, vorticity and temperature as dependent variables by iterative technique known as successive over relaxation. The flow and temperature patterns are obtained for Reynolds number and Grashof number at (Re= -50,50,100,-100) (positive or negative value refers to aidding or opposing buoyancy , +1 assisting flow, -1 opposing flow) and (102 to 105) , respective
... Show MoreBackground: Colorectal cancer is the third most common cancer-related mortality worldwide, and its prevalence is increasing among many nations. Aim of the study: Investigate the predictive value of carbohydrate antigen 242 (CA242) in comparison to the CEA biomarker and to estimate the significance of CA242 as prognosis maker in colorectal cancer patients. Methods: a case-control study with a total of 150 individuals, 100 patients (59 males, 41 females) and 50 healthy controls (26 males, 24 females). using an enzyme-linked immunosorbent (ELISA) to determine the serum levels of CA242 and CEA. The study was carried out at the gastroenterology consultation clinic of the oncology teaching hospital between November 2020 and February
... Show MoreFutsal and blind football are group games of a competitive nature due to their excitement, excitement, fun, and aesthetic goals with charming artistic touches. This explains the public's passion for these two games, whether healthy people or blind people play them, to expand their vision and knowledge. About these two games, a historical approach is presented about their origins, development, and how they became globally recognized competitive sports with unified rules and world championships at various levels. Studying the origin and global spread of both futsal and blind football and identifying the most prominent developments in the rules and tools for futsal and blind football. The most important findings were that both futsal and footb
... Show MoreSerum levels of iron,copper,ceruloplasmin and transferrine were estimated in three groups of patients with ?- thalassemia: 24 patients have splenectomy thalassemia major, 29 patients have non splenectomy thalassemia major and 19 patients have thalassemia intermedia , data were compared to normal and pathological controls (anemia and minor). There were significant increase in trace element levels in all studied groups of pateints as compared to normal and pathological controls. Also there were a significant increase in ceruloplasmin levels,While the result revealed that there were a significant decrease in transferrine levels in all groups of patients studied as compared to normal and pathological controls. The result also indicate that the
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