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.
Afamin, which is a human plasma glycoprotein, a putative multifunctional transporter of hydrophobic molecules and a marker for metabolic syndrome. Afamin concentration have been proposed to have a significant role as a predictor of metabolic disorders. Since NAFLD is associated with metabolic risk factors, e.g., dyslipidemia, insulin resistance and visceral obesity, it is considered as the hepatic manifestation of the metabolic syndrome. The objective of this study is to determine Afamin levels in hypothyroid patients with and without fatty liver disease and compare the results with controls. Also to study the relationship of Afamin level with the Anthropometric and Clinical Features (Age, Gender, BMI and Duration of Hypothyroidism) , Serum
... Show MoreDust and bird residue are problems impeding the operation of solar street lighting systems, especially in semi-desert areas, such as Iraq. The system in this paper was designed and developed locally using simple and inexpensive materials. The system runs automatically. It Connects to solar panels used in solar street lighting, and gets the required electricity from the same solar system. Solar panels are washed with dripping water in less than half a minute by this system. The cleaning period can also be controlled. It can also control, sensing the amount of dust the system operates. The impact of different types of falling dust on panels has also been studied. This was collected from different winds and studied their impact o
... Show MoreInterface bonding between asphalt layers has been a topic of international investigation over the last thirty years. In this condition, a number of researchers have made their own techniques and used them to examine the characteristics of pavement interfaces. It is obvious that test findings won't always be comparable to the lack of a globally standard methodology for interface bonding. Also, several kinds of research have shown that factors like temperature, loading conditions, materials, and others have an impact on surface qualities. This study aims to solve this problem by thoroughly investigating interface bond testing that might serve as a basis for a uniform strategy. First, a general explanation of how
... Show MoreInterface bonding between asphalt layers has been a topic of international investigation over the last thirty years. In this condition, a number of researchers have made their own techniques and used them to examine the characteristics of pavement interfaces. It is obvious that test findings won't always be comparable to the lack of a globally standard methodology for interface bonding. Also, several kinds of research have shown that factors like temperature, loading conditions, materials, and others have an impact on surface qualities. This study aims to solve this problem by thoroughly investigating interface bond testing that might serve as a basis for a uniform strategy. First, a general explanation of how the bonding strength
... Show MoreThe optical absorption data of Hydrogenated Amorphous Silicon was analyzed using a Dunstan model of optical absorption in amorphous semiconductors. This model introduces disorder into the band-band absorption through a linear exponential distribution of local energy gaps, and it accounts for both the Urbach and Tauc regions of the optical absorption edge.Compared to other models of similar bases, such as the O’Leary and Guerra models, it is simpler to understand mathematically and has a physical meaning. The optical absorption data of Jackson et al and Maurer et al were successfully interpreted using Dunstan’s model. Useful physical parameters are extracted especially the band to the band energy gap , which is the energy gap in the a
... Show MoreAcquisition provisions in Islamic jurisprudence
Dialogue is one of the most important means of calling to the Creator, as it is one of the scientific and verbal activities carried out by a group of interlocutors to present ideas they believe in, and evidence and proofs that express their views and demonstrate the reason for their belief in them, In order to arrive at the truth or a radical solution to a specific problem, so the interlocutor should pay attention to this science, study it and its etiquette, because the purposeful dialogue requires that the funniest of them be the most knowledgeable and knowledgeable about the axis of the hadith, and the funniest must also be able to be convinced of the rule of difference of opinion that does not spoil the issue of friendly They must also c
... Show MoreIn this study a new antiseptic was formulated and tested to match the effectiveness against microorganisms. The formulation consisted of Povidone - Iodine (PVP-I) (10%), H2O2 (3%) and Aloe Vera gel (pure). Different ratios of these materials were prepared within the acceptable range of pH for an antiseptic (3-6). The prepared samples were tested. The In Vitro test was performed by using four bacteria, two were Gram-Positive (Staphylococcus aureus and Bacillus cereus) and two were Gram-Negative (Escherichia coli and Pseudomonas aeruginosa). The new antiseptic showed 100% killing rate for E. coli, Ps. aeruginosa and S. aureus and 96.4667% killing rate for B. cereus. When the new antiseptic was compared with two common
... Show MoreThere are many varied studies that dealt with the dramatic construction, especially books and studies that addressed drama in its construction and the method of writing it, that no textbook or a general cultural content is void of tackling the dramatic text in its construction and how the dramatic action develops in it. Therefore, a question occurs to the mind about the feasibility of dealing with the dramatic construction in this time, where many contemporary studies of dramatology and its relation and the contemporary critical directions are accumulating. This question many have two realistic aspects, yet the novelty and originality that this research shows lie in addressing a refined linguistic text in its style and connotations, such
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