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.
Detecting the optimum layer for well placement, which requires a diverse assortment of tools and techniques, represents a significant challenge in petroleum studies due to its critical impact on minimizing drilling costs and time. This study aims to evaluate integrated geological, petrophysical, seismic, and geomechanical data to identify the optimum zones for well placement. Three different reservoirs were analyzed to account for lateral and vertical variations in reservoir properties. The integrated data from these reservoirs provides many tools for reservoir development, especially to detect appropriate well placement zones based on evaluations of reservoir and geomechanical quality. The Mechanical Earth Model (MEM) was construct
... Show MoreBackground: University dental students perceived a higher level of stress prior to the final exam associated with raised salivary cortisol levels which could be considered as a useful noninvasive biomarker for measuring acute stress. Using a Helkimo anamnestic and clinical dysfunction scoring for temporomandibular disorders can give a better insight about the association of this marker and temporomandibular joint disorders. The aim of this study was to evaluation level of salivary cortisol in stressor students with temporomandibular disorder and the relation between this marker in relation to temporomandibular disorder severity. This might give a better understanding to the role of psychological stress as an etiological factor for developin
... Show MoreThis research was conducted to measure the safety of heat stable enterotoxin a (STa) produced by enterotoxigenic Escherichia coli, through studying its toxic effect on mice since it showed a promising effect in reducing the proliferation of colorectal cancer cells. The cytogenetic effect was determined after giving five different doses (100, 200, 400, 800 and 1600)μg/Kg in comparison with negative (phosphate buffer saline / PBS) and positive (mitomycin C/ MMC, at doses of 2 and 5μg/Kg) controls on mouse bone marrow cells by employing the following parameters: mitotic index, chromosomal aberrations and micronucleus, also, the serum level of liver functional enzymes (GOT, GPT, ALP) was recorded. In addition, lethal dose 50 (LD 50) with cert
... Show MoreOne of the main parts in hydraulic system is directional control valve, which is needed in order to operate hydraulic actuator. Practically, a conventional directional control valve has complex construction and moving parts, such as spool. Alternatively, a proposed Magneto-rheological (MR) directional control valve can offer a better solution without any moving parts by means of MR fluid. MR fluid consists of stable suspension of micro-sized magnetic particles dispersed in carrier medium like hydrocarbon oil. The main objectives of this present research are to design a MR directional control valve using MR fluid, to analyse its magnetic circuit using FEMM software, and to study and simulate the performance of this valve. In this research, a
... Show MoreThe Reasons behind the decadence of the studies concerning the evening school in Salah al Deen A field study
Crime is one of the most severe challenges facing States, and strives to find preventive measures, reduce its seriousness, and prevent them; due to developments, crimes have increased, and emerging new patterns of crimes, there is an urgent need to prevent crimes and reduce their effects. Modernizing its punitive system and diverting it to correctional rehabilitative justice to redress the prejudice caused by the crime and rehabilitate the convicted person by using alternative measures to short-term imprisonment. This research emphasizes alternative sanctions' value to minimizing short-term imprisonment penalties and their impact on societal security through several goals like, the negative consequences, justifications, and alternatives
... Show MoreIt is a moral presumption that includes the object for its sake, and it is called the object for it or the object for its sake, which is the present tense after (lam, ki, fa, willn, and then), and it is not an excuse for the occurrence of the matter (1), and it requires a connection between the two sides of (a cause with a cause) united by a reason for a specific purpose (2). The object has a reason or an excuse, because it is an explanation of what came before it, of the cause. The reason for the occurrence of the action, being the motive for causing the action and the bearer of it (3), indicates that the infinitive is restricted to a special reason. So if I said: (I came to you with the hope of honoring you), then I attributed the coming
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