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.
In this review, numerous analytical methods to distinguish pigments in tattoo, paint, and ink items are discussed. The selection of a method was dependent upon the purpose, e.g., quantification or identification of pigments. The introductory part of this review focuses on describing the importance of setting up a pigment-associated safety profile. The formation of different degradation chemical substances as well as impurity trends can be indicated through the chemical investigation of pigments in tattoo products. It is noteworthy that pigment recognition in tattoo inks can work as a preliminary method to identify the pigments in a patient's tattoo before being removed by laser therapy. Contrary to the stud
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This research is based on the descriptive and analytical methodology. The importance of studying labor laws and labor unions in Japan between 1889 and 1946 constitutions is because Japan was out of a feudal phase, and had no idea about the factory system and industrialization in their modern sense before the Meiji era. Generally, its labor system used to be mostly familial, and the economic system was based on agriculture. This called for the enactment of legislations and laws appropriate for the coming phase in Meiji era. Thus, this paper examines the role of Meiji government in enacting labor legislations and laws when he came to power in 1896, and his new constitution in 1889 and the civil code of 1896. It further examines the way Mei
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The posterior regions of the jaws usually represent a significant risk for implant surgery. A non-valid assessment of the available bone height may lead to either perforation of the maxillary sinus floor or encroachment of the inferior alveolar nerve and consequently to implant failure. This study aimed to evaluate the reliability of surgeon’s decision in appraising the appropriate implant length, in respect to vital anatomical structures, using panoramic radiographs.
Only implants that are inserted in relation to the maxillary sinus (MS) or the mandibular canal (MC) were enrolled
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This study aims to analyze the messages of a number of global news outlets on Twitter. In order to clarify the news outlets tactics of reporting, the subjects and focus during the crisis related to the spread of the Covid-19 virus. The study sample was chosen in a deliberate manner to provide descriptive results. Three news sites were selected: two of the most followed, professional and famous international news sites: New York Times and the Guardian, and one Arab news site: Al-Arabiya channel.
A total of 18,085 tweets were analyzed for the three accounts during the period from (1/3/2020) to (8/4/2020). A content analysis form was used to analyze the content of the news coverage. The results indicate an increase in th
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The objective of this study is to explain the role of credit policies in agricultural development of Iraq during the period 1979-1989 which were represented by the policy of co-operative agricultural bank the organization that responsible to finance agricultural sector for various reasons. It has been shown that there was no clear credit policy existed during the period concerned due to the differences between loans from year. The loan growth rate was low in general comparing with objectives of the agricultural development plans, a low production rates comparing with loans paid, the growth rate of average number of trees in each donum and the growth rate of livestock number was also low.In conclusion there should be a clear plan for cred
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Objective: To compare distal tibia nonunion plating and grafting with and without platelet-rich plasma (PRP) regarding union rate, union time and complications Conclusion: Combining PRP with autologous bone graft results in a higher union rate, less healing duration, less post-operative pain, and more callus formation. (Rawal Med J 202;45:629- 632). Methodology: In this prospective comparative study, 32 patients with nonunion tibia from July 2017 January 2019 were divided into two groups: group A (16 cases) were treated by plating and grafting with PRP and group B (16 cases) were treated by plating and grafting only. Keywords: Tibial nonunion, bone graft, plateletrich plasma. Results: There was higher union rate in group A related to group
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