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.
Many economists believe that the development and promotion of small and medium-sized enterprises is one of the most important sources of economic and social development in countries in general and in developing countries in particular. This is considered to be an essential starting point for increasing production capacity and contributing to tackling poverty and unemployment. In view of the importance of these projects, most developing countries have concentrated their efforts on them. They have encouraged the establishment of small and medium industries, especially after they have proved their ability and efficiency in dealing with the major problems facing different economies.
The banking system plays an important role by finan
... Show MoreMany studies of the relationship between COVID-19 and different factors have been conducted since the beginning of the corona pandemic. The relationship between COVID-19 and different biomarkers including ABO blood groups, D-dimer, Ferritin and CRP, was examined. Six hundred (600) patients, were included in this trial among them, 324 (56%) females and the rest 276 (46%) were males. The frequencies of blood types A, B, AB, and O were 25.33, 38.00, 31.33, and 5.33%, respectively, in the case group. Association analysis between the ABO blood group and D-dimer, Ferritin and CRP of COVID-19 patients indicated that there was a statistically significant difference for Ferritin (P≤0.01), but no-significant differences for both D-dimer and CRP.
... Show MoreCerebral palsy "is one of the diseases that afflict children, and it is a term given to the condition of a child who is exposed to a normal brain injury by accident due to its inability to grow or damage to the cells of the areas responsible for movement and knowledge of strength and balance during the stage of normal development." (116: 1999: 10) Cerebral palsy causes disruption in movement and posture due to damage to brain cells in areas that control and coordinate muscle tone, reflexes, strength, and movement. The degree and location of brain damage varies greatly between people with paralysis, as well as the severity of disability and symptoms, as they fall into severe to very simple, and cerebral palsy is one of the diseases that caus
... Show MoreIntroduction Periodontal diseases are ranked among the most common health problems affecting mankind. These conditions are initiated by bacterial biofilm, which is further modulated by several risk factors. Objectives To investigate the association of different risk factors with periodontal...
A simple straightforward mathematical method has been developed to cluster grid nodes on a boundary segment of an arbitrary geometry that can be fitted by a relevant polynomial. The method of solution is accomplished in two steps. At the first step, the length of the boundary segment is evaluated by using the mean value theorem, then grids are clustered as desired, using relevant linear clustering functions. At the second step, as the coordinates cell nodes have been computed and the incremental distance between each two nodes has been evaluated, the original coordinate of each node is then computed utilizing the same fitted polynomial with the mean value theorem but reversibly.
The method is utilized to predict
... Show MoreOne of the most popular and legally recognized behavioral biometrics is the individual's signature, which is used for verification and identification in many different industries, including business, law, and finance. The purpose of the signature verification method is to distinguish genuine from forged signatures, a task complicated by cultural and personal variances. Analysis, comparison, and evaluation of handwriting features are performed in forensic handwriting analysis to establish whether or not the writing was produced by a known writer. In contrast to other languages, Arabic makes use of diacritics, ligatures, and overlaps that are unique to it. Due to the absence of dynamic information in the writing of Arabic signatures,
... Show MoreThe Love Creek Nature Center, one of the three nature centers located within the boundaries of Berrien County, is owned and operated by the county for public enjoyment and instruction of nature. The 44.5 ha study area, located seven km east of Berrien Springs, and two km southwest of Berrien Center, on Huckleberry Road, in T6S, R17W, sections 16, 17 (Lat. 41° 56' N; Long. 86° 18' W) is made up of deciduous woods and abandoned fields at various stages of succession. It is bounded on the east by the Berrien County Dog Pound and Huckleberry Road, to the north by cultivated Berrien County land and the Berrien General Hospital, to the west by the recently closed Berrien - Oronoko Township Landfill Dump; and to the south b
... Show MoreThe involvement of maxillofacial tissues in SARS‐CoV‐2 infections ranges from mild dysgeusia to life‐threatening tissue necrosis, as seen in SARS‐CoV‐2‐associated mucormycosis. Angiotensin‐converting enzyme 2 (ACE2) which functions as a receptor for SARS‐CoV‐2 was reported in the epithelial surfaces of the oral and nasal cavities; however, a complete understanding of the expression patterns in deep oral and maxillofacial tissues is still lacking.
The immunohistochemical expression of ACE2 was analyzed in 95 specimens from maxillofacial tissues and 10 specimens o