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.
Discretionary Punishment, Public Regulation, Interest
This study depicts the removal of Manganese ions (Mn2+) from simulated wastewater by combined electrocoagulation/ electroflotation technologies. The effects of initial Mn concentration, current density (C.D.), electrolysis time, and different mesh numbers of stainless steel screen electrodes were investigated in a batch cell by adopting Taguchi experimental design to explore the optimum conditions for maximum removal efficiency of Mn. The results of multiple regression and signal to noise ratio (S/N) showed that the optimum conditions were Mn initial concentration of 100 ppm, C.D. of 4 mA/cm2, time of 120 min, and mesh no. of 30 (wire/inch). Also, the relative significance of each factor was attained by the analysis
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Antibiotic resistance has been a growing worldwide public health issue. The World Health Organization (WHO) has stated that the search for new antibiotics is slow, while antibiotic resistance is growing. WHO has also declared that antibiotic resistance is one of the top 10 global public health threats facing humanity in the 21st century. Therefore, this review discusses the potential of metal-based drugs as antibacterial agents from the period of the early 2000s to date. The review reveals that a lot of preliminary work has been done to assess these as potential drugs. However, their mode of action is faintly described. Furthermore, a few examples of metal-based drugs assessed for their modes of action are described. These compounds are ide
... Show MoreThe current research aims to identify the effect of the learning mastery strategy using interactive learning as a therapeutic method on the achievement of secondary school students in mathematics. To achieve the research objective, the researcher selected second-grade middle school students at Al-Haybah Intermediate School for Boys and determined his research sample, which consisted of (77) students distributed into two sections: Section (A) the experimental group, with (38) students, and Section (B) the control group, with (39) students. The statistical equivalence of the two research sample groups was confirmed in the variables (intelligence test, previous achievement, and previous knowledge test). The researchers chose the par
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Despite the great economic and commercial importance given to real estate by virtue of its view of the landscape or public roads, US courts have differed in their position on compensation for damages resulting from blocking that view or vision by public projects. Some courts compensated for such damages, other courts approved such compensation. Hence, this research came to shed light on the extent of the possibility of compensation for blocking the view or vision as a result of public projects, and the research has supported us with many judicial decisions.
The earth's surface comprises different kinds of land cover, water resources, and soil, which create environmental factors for varied animals, plants, and humans. Knowing the significant effects of land cover is crucial for long-term development, climate change modeling, and preserving ecosystems. In this research, the Google Earth Engine platform and freely available Landsat imagery were used to investigate the impact of the expansion and degradation in urbanized areas, watersheds, and vegetative cover on the land surface temperature in Baghdad from 2004 to 2021. Land cover indices such as the Normalized Difference Vegetation Index, Normalized Difference Water Index, and Normalized Difference Built-up Index (NDVI, NDWI, an
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The research included five sections containing the first section on the introduction o research and its importance and was addressed to the importance of the game of gymnastic and skilled parallel bars effectiveness and the importance of biochemical variables, either the research problem that there is a difference in learning this skill and difficulty in learning may be one of the most important reasons are falling and injury Has a negative impact on the performance and lack of sense of movement of is one of the obstacles in the completion of the skill and the goal of research to design a device that helps in the development of biochemical changes to skill of rear vault dismount with one-half twist on parallel bars in gymnastics . And the n
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