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.
Objective: To evaluate male patients complaining of
urethritis clinically according to the isolated organisms.
Method: A total of 100 male patients attending to of
Dermatological and Venereal private clinics for the period
April 2003 to November 2003 were included in the study.
Urethral swab was obtained from each male for culture and
direct immunofluorescence examination was done.
Demographic data was obtained, also.
Results: N. gonorrhoea was the predominate cause of
infection in 22%. A peak of infection was reported in the
second decade of age. Highest rate reported among single
males. A significant association was noticed between
profuse discharge and infection with gonorrhoea.
Conclusion: This
Background: Humeral diaphyseal fracture usually
heals with closed methods but when nonunion
develops then it needs surgical intervention in the
form of plating and bone grafting, intramedulary
nailing (open or closed simple or interlocking nails)
and external fixators (circular or one plane fixator).
In our unit we treated non union humeral
diaphyseal fracture with plating and bone grafting
shortening of fracture ends up to 4 to 5cm when
needed. Methods: This study was conducted at
Orthopaedic Department of AL-Sadar General
Hospital from January 2004 till December2005 .
We included 20 cases with atrophic non-union in
12(60%) and hypertrophic non-union in 8 (40%)
patients. All atrophic non-union w
Abstract
The article is devoted to the study of modal framework of the utterance with the semantics of “disappearance” in modern Russian language. The empirical basis of the study was the works of Russian writers, such as M.A. Bulgakov, F.M. Dostoevsky, A.I. Kuprin., L.M. Leonov, B.L. Pasternak, K.G. Paustovsky, L.N. Tolstoy, I.S. Turgenev and others. The author focuses special attention on the role of the modal component in the formation of the sentences and its modal semantics. A lot attention is paid to the analysis of the reasons of productivity / low productivity in the functioning of the temporal forms of the verbs that form these utterances. The nature of the material of study determined the choice of
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The study of the future of the international system currently appears, according to scientific data and existing facts in light of the emergence of international actors from non-states and international informal institutions, to be heading towards a non-polarity system and this trend is fueled by many variables to reduce polarity, and it is expected in the future that the international system will turn into a non-polarity.
In Iraqi patients with acromegaly the present investigation included 40 control group and 70 patients with acromegaly divided 35 patients with Diabetic while another 35 patients without Diabetic, with ages between (29-72) years for the identification of GST activity polymorphisms by present and absent GSTM1, GSTT1, and PCR-RFLP, enzymatic digestions were carried out using BsmAI (Biolabs. England, UK) for GSTP1b and AciI (Biolabs, England, UK) for GSTP1c.the association GSTActivity with GST genotype were investigated in a cohort of Iraq acromegaly patients comparing with the healthy control group. The results show a non-significant change in GSTP1b gene in both groups, while show high significantly in GSTP1c in diabetic and non-diabetic acro
... Show MoreBased on a finite element analysis using Matlab coding, eigenvalue problem has been formulated and solved for the buckling analysis of non-prismatic columns. Different numbers of elements per column length have been used to assess the rate of convergence for the model. Then the proposed model has been used to determine the critical buckling load factor () for the idealized supported columns based on the comparison of their buckling loads with the corresponding hinge supported columns . Finally in this study the critical buckling factor () under end force (P) increases by about 3.71% with the tapered ratio increment of 10% for different end supported columns and the relationship between normalized critical load and slenderness ratio was g
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Sotileza , localismo santandrino de sutileza , es la parte más fina del aparejo de pescar donde va el anzuelo. Es la obra maestro de José María de Pereda.Su ambiente , el Santander viejo, anterior al año 50,evocado emocionadamente - emociόn romántica contenida en los trazos sobrios y firmes de un naturalism psicolόgico y paisajista,el Santander que el autor confiesa poseer en el fondo de su corazόn,«y tenerlo esculpido en la memoria de tal suerte que ,a ojos cerrados,me atrevería a trazarle con todo su perímetro y sus calles, y el color de sus piedras, y el número, y los nombres, y hasta las caras de sus habitantes».Dentro de la grandeza primaria de las criaturas de Pere
... Show MoreThe aim of the study was to find out the correlations and impact between the variable of ethical leadership behavior and university performance at Sumer University. Use the descriptive analytical method by adopting the questionnaire tool to collect data. The questionnaire was distributed electronically to 113 teachers at Sumer University and the response was from 105 teachers. The research results showed that there is a correlation and effect relationship between the search variables. In addition, the responding university does not have ethically defined standards in terms of performance of the work of the cadres working there. Finally, the research presented a set of recommendations aimed at tackling problems in the ethical lead
... Show MoreThis title may have something strange or paradoxical; it is unusual or natural to look for violence in literature, or that literature is a tool for killing through the contribution of writers and poets in generating, feeding or advocating violence. The Zionist literature belongs to the 20th century, is almost the only literature among the etiquette of peoples, which professes racism and boasts of betraying its human role, and wants to be a vehicle for terrorism domination. It also tends to be a means in the hands of killers and adventurers. Writers of this Literature show that no solution to the Jewish problem is only by Zionist presence to replace the Palestinian presence and to build the state of "Israel" on the ruins of Pa
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In this study, gold nanoparticle samples were prepared by the chemical reduction method (seed-growth) with 4 ratios (10, 12, 15 and 18) ml of seed, and the growth was stationary at 40 ml. The optical and structural properties of these samples were studied. The 18 ml seed sample showed the highest absorbance. The X- ray diffraction (XRD) patterns of these samples showed clear peaks at (38.25o, 44.5o, 64.4o, and 77.95o). The UV-visible showed that the absorbance of all the samples was in the same range as the standard AuNPs. The field emission-scanning electron microscope (FE-SEM) showed the shape of AuNPs as nanorods and the particle size between 30-50 nm. Rhodamine-610 (RhB) was prepared at 10<
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