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.
Abstract
The current research aims to identify the effectiveness of social stories in increasing social interaction among children with an autism spectrum disorder. The researcher used the single-subject design methodology (Single Subject Designs, SSD) with
(A-B) design to answer the research questions. The study sample consisted of (3) children with autism spectrum disorder enrolled in a transit daycare center in the Asir region, Saudi Arabia. The results of the study showed that there is a positive functional relationship between social stories and play to increase social interaction among children with autism spectrum disorder, which contributed to the acquisition and generalization of this behav
... Show MoreThis study aimed to find relationship between thymidine kinase-1 (TK-1) as tumor marker and total antioxidant capacity (TAC) in Iraqi children patients with thrombocytopenia and with thrombocytosis. The present study conducted 60 children patients (30 patients with idiopathic thrombocytopenia purpura (ITP) and 30 patients with thrombocytosis caused by leukemia) attending the Children Fever Hospital in the Medical City / Baghdad, and 30 healthy children as a control group. All study groups were with range ages (1-15) years, and they were diagnosed by assay of platelet count, Prothrombin Time (PT), and partial Thromboplastin Time (PTT). The results shown elevation in plasma TK-1 and TAC values in children patients with thrombocytopenia and w
... Show MoreIn this study, hydroxyapatite (HAP, Ca10(PO4)6(OH)2) has been prepared as bioceramic material with biological specifications useful to used for orthopedic and dental implant applications. Wet chemical processing seems to form the fine grain size and uniform characteristic nanocrystalline materials by the interstice factors controlling which affected the grain size and crystallinity in order to give good mechanical and/or constituent properties similar as natural bone. Fluorinated hydroxyapatite [4-6 wt% F, (FHA, Ca10(PO4)6(OH)2–Fx] was developed in new method for its posses to increased strength and to give higher corrosion resistance in biofluids than pure HAP moreover reduces the risk of dental caries. The phase's and functional groups
... Show MoreIn this paper, a simple fast lossless image compression method is introduced for compressing medical images, it is based on integrates multiresolution coding along with polynomial approximation of linear based to decompose image signal followed by efficient coding. The test results indicate that the suggested method can lead to promising performance due to flexibility in overcoming the limitations or restrictions of the model order length and extra overhead information required compared to traditional predictive coding techniques.
In this work ,medical zinc oxide was produced from zinc scraps instead of traditional method which used for medical applications such as skin diseases, Iraq is importing around 50 ton/year for samarra plant the producted powder has apartical size less than 5 micron and the purity was more than 99.98%,also apilot plant of yield capacitiy 15 kg/8hours wsa designed and manufactured .
This research study Blur groups (Fuzzy Sets) which is the perception of the most modern in the application in various practical and theoretical areas and in various fields of life, was addressed to the fuzzy random variable whose value is not real, but the numbers Millbh because it expresses the mysterious phenomena or uncertain with measurements are not assertive. Fuzzy data were presented for binocular test and analysis of variance method of random Fuzzy variables , where this method depends on a number of assumptions, which is a problem that prevents the use of this method in the case of non-realized.
Organizations must interact with the environment around them, so the environment must be suitable for that interaction. These companies are now trying to become Learning Organizations because it try to face that challenges may rise from its environments. The Learning Organization is a concept that is becoming an increasingly widespread philosophy in modern companies, from the largest multinationals to the smallest ventures. What is achieved by this philosophy depends considerably on one's interpretation of it and commitment to it. This study gives a definition that we felt was the true ideology behind the Learning Organization and Group Working. A Learning Organization is one in which people at all levels
... Show More