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.
Purpose: The research seeks to develop the implications of intellectual human capital, and social capital in business organizations, and will be accomplished on three levels, the first level (the level of description) to identify, diagnose and display content philosophical Strategic Human Resource Management at the thought of modern administrative represented by human capital and Ras social capital. The second level (level of analysis) and the analysis of the extent of the impact of alignment between human capital, and social capital in the organizational strength of the organizations. The third level (Level predict) the formulation of a plan to strengthen the organizational strength in business organizations and to develop speci
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The research is concerned with studying the characteristics of Sustainable Architecture and Green Architecture, as a general research methodology related to the specific field of architecture, based on the differentiation between two generic concepts, Sustainability and Greening, to form the framework of the research specific methodology, where both concepts seem to be extremely overlapping for research centers, individuals, and relevant organizations. In this regard, the research tend towards searching their characteristics and to clearly differentiates between the two terms, particularly in architecture, where the research seeks understanding sustainable and green architectures, how they are so close or so far, and the
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Caring for and treating a child's health is an important need to achieve optimal health? It is a concept that reaches beyond mere recovery from illness. It's achieved by balancing the different aspects of the child, including physical, psychological, mental, and spiritual aspects.A sick child needs therapeutic environments that provide medical care in a way that accelerates the recovery process. The therapeutic environment for the child prefers to be positive and conscious with its incentives that enhance the child's ability to receive treatment, reduce their fear and anxiety and distract them from the disease, which provokes positive feelings and helps them to recover quickly.Here comes the great role that pediatric hospitals play
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The present work was done in an attempt to build systematic procedures for treating warts by 810 nm diode laser regarding dose parameters, application parameters and laser safety. The study was done in Al- Kindy Teaching Hospital in Baghdad, Iraq during the period from 1st October 2003 till 1st April 2004. Fifteen patients completed the treatment and they were followed for the period of 3 months. Recalcitrant and extensive warts were selected for the study. Patients were randomly divided into 3 groups to be treated by different laser powers 9, 12 and 15 W, power density of 286 W/cm2, 381W/cm2, 477 W/cm2 pulse duration of 0.2 s, interval of 0.2 s and repeated pulses were used. The mode of application was either circular or radial. Pain oc
... Show MoreThis study aims at discussing how gender differences might affect communication among people. For this purpose, several TV interviews are selected and examined on the discourse level. Developing a model of analysis ,is found that certain linguistics have been used by male speakers ,whereas different aspects have been utilized my female speakers like deictic expressions and lexical items of emotion and delicacy .
Background: Neonatal hyperbilirubinemia is a prevalent condition commonly treated with phototherapy. While effective, phototherapy can cause adverse effects such as dehydration and maternal separation, necessitating complementary care strategies. Objectives: This systematic review aims to evaluate the efficacy of foot reflexology and related tactile interventions on bilirubin levels and physiological parameters in neonates undergoing treatment for hyperbilirubinemia. Methods: A systematic search was conducted across five electronic databases (PubMed, Scopus, Web of Science, Google Scholar, and Cochrane Library) for studies published between 2019 and 2025. The review followed the PRISMA guidelines and PICOS framework. Twenty studies,
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