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.
The current world seeks to supply the most of the fruits of human knowledge and tries hard to search for the most important scientific facts, programs, means and advanced devices in various fields, including the sports field, and among these means is the use of various and advanced training devices and programs for the purpose of achieving the desired goal, which is to reach the desired level, the basketball game is one of the sports that need high technology in training according to scientifically studied principles because it is one of the games that relate to the abundance of its variables, composition and speed of change, all of which require a technical and high training depth and the players ’possession of different physical charact
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Summary
The book (Fatah al-Rahman reveals what is ambiguous in the Qur’an), which is a book of verbal similarities that tries to touch the Qur’an expression, and the subtle differences between its expressions and expressions. It appeared when it appeared in many chapters, from which I chose to delete in monolithic letters such as Ba and Ta, and to heal and delete in non-monosymbols such as (that) and (may) and (no), so the search came to two chapters The first is for deleting the monolithic letters, and the second is for deleting non-monosyllabic letters, preceded by introductory discussions revolving around the linguistic and idiomatic definition of deletion, a brief translation of the
... Show MoreKE Sharquie, SA Al Mashhadani, AA Noaimi, RK Al-Hayani, SA Shubber, Iraqi Postgraduate Medical Journal, 2012 - Cited by 1
This research aimed to definite Blending learning (BL) technique, and to know the impact of its use onacademic achievement in Biology course of second class students in secondary special schools in Omdurman Locality and attitudes towards it, to achieve this; researcher adopted the experimental method. The sample was selected of (41) students, chosen from Atabiyah school, were divided into two equals groups: one experimental group reached (26) students studied by using the BL technique, and the second control group (25) students have been taught in the traditional method.
Data has collected by using two tools: achievement test and a questionnaire for measuring the attitudes towards Blend
... Show MoreIn this work the strain energy of tetrahedrane and its nitrogen substituted molecules were calculated by isodesmic reaction method according to DFT quantum chemical fashion, the used basis set was 6-31G/B3-LYP, in addition all structures were optimized by RM1 semi-empirical method. From the obtained data we estimate an empirical equation connect between strain energy of the molecule with charge functions represented by dipole moment of the molecule plus accumulated charge density involved within the tetrahedron frame plus the number of nitrogen atoms. The results indicate the charge spreading factors by polarization and processes are the most important factors in decreasing the strain energy.
The field study of this paper focused on the motives for lawyers to use the website
of the Supreme Judicial Council, and the gratifications achieved as a result of its use.
This study sought to achieve a number of goals, including:
1. Monitoring the patterns of lawyers’ use of the website of the Supreme Judicial Council.
2. Determining the forms that lawyers use to interact on the website of the Supreme
Judicial Council.
This study is a descriptive in kind as the researcher relied on the ‘survey method’ in
its study of the external audience (lawyers) using the questionnaire and scale toolThe questionnaire was distributed among a deliberately chosen sample, consisting of
(160) lawyers who used the website of
I dealt with this study of one of the hadiths of the Prophet and judged him after studying his deed, especially one of his narrations for the similarity in his name and the name of his father (Abdul Rahman bin Ishaq) Is he a civil "Sadok" or Wasti "weak" and they are in one layer which is called in the science of Hadith (agreed And after a review of Kutkut translations and wound and amendment and other evidence and evidence that it was "weak" and not as he went to him and asserted by the updated Muhammad Nasser al-Din al-Albani may God have mercy on him that in Sindh is a civil rule for the hadeeth "Hassan" and not as said The hadeeth is “weak” because he showed that it is the weak Wasti.
I ask God to be successful in this work an
Klebsiella pneumoniae is among the most frequent microorganisms isolated from infections of burn wounds. This cross-sectional study aimed to investigate the distribution of multi-drug resistant (MDR) K. pneumoniae in two burn hospitals and the antibiotic resistance profile in different burn regions of the same patient. It was performed in two hospitals (Al-Zahraa and Al-Karama) in Al-Kut, Iraq, between January and May 2022. Totally, 100 burn swabs were collected from 40 patients of both genders suffering from burn wound infections, with ages ranging between 3 and 50 years. Klebsiella pneumoniae were isolated and identified using conventional methods followed by VITEK®2 system and confirmed via polymerase chain reaction targeting t
... Show MoreNonalcoholic fatty liver disease (NAFLD) is a common liver disease that ranges from simple steatosis to nonalcoholic steatohepatitis (NASH). So far, the underlying mechanism remains poorly understood. Here, we show that hepatic carboxylesterase 2 (CES2) is markedly reduced in NASH patients, diabetic