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.
Praise be to God, Lord of the worlds, and peace and blessings be upon our master Muhammad, and upon his whole family and companions, but after: God Almighty has instituted types of acts of worship and classes of obedience that, if performed by the servant, would link him with his Creator and connect with his Lord. And for the sake of these worship, and the greatest of them: the worship of i'tikaaf, for souls need rest and recuperation from the struggle of life and its concerns, concerns and anguish, and people differ in their attitudes and interests in the means of recreation, and many people consider the outing and travel the best way in which they breathe from their toil and toil, and reclaim their strength and the advised adult He fin
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The aim of the research is to identify the impact of the areas of organizational change in strategic marketing planning in cement factories operating within the city of Al-Khums, and this effect was measured using a questionnaire consisting of 28 phrases, and it was relied on the descriptive approach that suits the nature of the subject of the research, while the research community consists of heads And members of the board of directors, authorized managers, unit managers and heads of departments in the factories under study, which numbered 55 respondents, during the month of September of the year 2021, and a sample of the compreh
... Show MoreThe emergence of the Internet and its transformation in the early nineties of the last century led to a means of mass communication that brought about significant structural changes in the media map.
Over the course of historical development, the public did not engage the media in its behavior in the implementation and dissemination of an idea, generalization or theory put forward by media experts or practitioners through these means to do it. Blogs represent the most important service provided by the Internet in recent years which has gained special importance in the media field. Where the word “Blogs” has several names: (alternative media), (blogging press), (popular press) and other names.
The medi
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The results showed that the organic fertilizer mixture (1:1) 30 tons/ha with chemical fertilization recorded the lowest level of bulk density of 1.2 g/cm3, the organic fertilizer mixture (1:1) 30 tons/ha with chemical fertilization recorded the highest percentage of aggregation stability amounting to 16.17%, the organic fertilizer palm fronds recorded the highest level of ready water with an average of 5.50 cm3/cm3 and the organic fertilizer mixture (1:1) 30 tons/ha without chemical fertilization recorded the highest level of ready water as it reached 6.93%, the or
... Show MoreApplications of quantitative methods, which had been explicit attention during previous period (the last two centuries) is the method of application sales man or traveling salesman method. According to this interest by the actual need for a lot of the production sectors and companies that distribute their products, whether locally made or the imported for customers or other industry sectors where most of the productive sectors and companies distributed always aspired to (increase profits, imports, the production quantity, quantity of exports. etc. ...) this is the part of the other hand, want to behave during the process of distribution routes that achieve the best or the least or most appropriate.
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Objective of the research This study aimed to manufacture an innovative device that enables the player to walk after the operation and improves functional efficiency through improvement in the range of motion as well as improvement in the size of the muscles working on the knee joint Imposing research There are statistically significant differences between the pre and posttests of the experimental and control groups, there are Statistically significant differences between the post-tests between the experimental group and the control group in favor of the experimental group of the research sample. The researchers used the experimental approach by designing the control and experimental groups with a test (pre-post) for the suitabili
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Based on analyzing the properties of Bernstein polynomials, the extended orthonormal Bernstein polynomials, defined on the interval [0, 1] for n=7 is achieved. Another method for computing operational matrices of derivative and integration D_b and R_(n+1)^B respectively is presented. Also the result of the proposed method is compared with true answers to show the convergence and advantages of the new method.
The aim of the current study is to create special norms of the second edition of Minnesota multi faces personality inventory, and the fifth edition of the sixteen personality factor questionnaire of catel. To this end, the researcher applied the Minnesota multi faces personality inventory over a sample of (1646) secondary and university students as well as plenty of disorders. She also applied the sixteen personality factor questionnaire of catel on (4700) secondary and university students. SPSS tools were used to process data.
The concept of fully pseudo stable Banach Algebra-module (Banach A-module) which is the generalization of fully stable Banach A-module has been introduced. In this paper we study some properties of fully stable Banach A-module and another characterization of fully pseudo stable Banach A-module has been given.
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This study introduced the effect of using magnetic abrasive finishing method (MAF) for finishing flat surfaces. The results of experiment allow considering the MAF method as a perspective for finishing flat surfaces, forming optimum physical mechanical properties of surfaces layer, removing the defective layers and decreasing the height of micro irregularities. Study the characteristics which permit judgment parameters of surface quality after MAF method then comparative with grinding