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.
Maxillofacial trauma in females is not widely reported. This study aimed to analyze the clinical characteristics and the patterns of maxillofacial injuries in females and to determine the differences in these patterns among different causes. This retrospective study analyzed several variables, including demographic, social, injury-related, and treatment-related variables, and compared these variables in relation to the main etiologies of maxillofacial trauma. The main etiologies of maxillofacial injuries involving females were assault, followed by road traffic accidents, and falls. There were significant differences in relation to the 3 etiologies in age groups (
In This paper, we introduce the associated graphs of commutative KU-algebra. Firstly, we define the KU-graph which is determined by all the elements of commutative KU-algebra as vertices. Secondly, the graph of equivalence classes of commutative KU-algebra is studied and several examples are presented. Also, by using the definition of graph folding, we prove that the graph of equivalence classes and the graph folding of commutative KU-algebra are the same, where the graph is complete bipartite graph.
In this research, we highlight the most important research related to the mixed ligand complexes of the drug trimethoprim (TMP), and for the past 7 years where this drug has been used as a chelating ligand and gives stability to the complexes with ions of metal elements where these complexes, prepared and diagnosed, and for some research the bacterial activity was studied against different types of bacteria.
The current study aimed to review previous scholarly efforts to understand the concept of sustainable development, its practices, and its significance for public institutions. The study focuses on the dimensions of sustainable development—environmental, social, and economic—within public institutions. Sustainable development allows these institutions to balance environmental protection, economic growth, and social justice, ensuring the prosperity of both current and future generations. Furthermore, sustainable development is crucial for maintaining organizational performance. The review bridges knowledge gaps related to sustainable development and utilizes an analytical approach, surveying previous studies on the topic. The sele
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Aggression is a negative form of an anti-social behavior. It is produced because of a particular reason, desire, want, need, or due to the psychological state of the aggressor. It injures others physically or psychologically. Aggressive behaviors in human interactions cause discomfort and disharmony among interlocutors. The paper aims to identify how aggressive language manifests itself in the data under scrutiny in terms of the pragmatic paradigm. Two British literary works are the data; namely, Look Back in Anger by John Osborne (1956), and The Birthday Party by Harold Pinter (1957). This paper endeavors to answer the question of how aggressive language is represented in literature pragmatically? It is hoped to be significant to
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Vitamin A, namely retinol is still the most proper agent for modulating so many biochemical reactions and biological functions in different tissues and organs. In addition to the provitamins A and α, βand γ-carotenoids that are present in various foods from either animal or plant origin, retinoids and rexinoids form the natural and synthetic analogs that are chemically related or unrelated and can be added as food supplements for deficiency disorders of vitamin A or used to alleviate or treat certain health problems such as skin carcinoma, acne, skin aging and dermatitis.
Variable-Length Subnet Masks (VLSM), often referred to as "subnetting a subnet", is used to maximize addressing efficiency. The network administrator is able to use a long mask on networks with few hosts, and a short mask on subnets with many hosts. This addressing scheme allows growth and does not involve wasting addresses. VLSM gives a way of subnetting a network with minimal loses of IP addresses for a specific range. Unfortunately, the network administrator has to perform several mathematical steps (or use charts) to get the required results from VLSM. In this paper, a simple graph simulator is proposed (using Visual Basic 6.0 Language) to perform all the required mathematical steps and to display the obtained required information (the
... Show MoreSummaryBackground: Rotavirus infection is the most commoncause of watery viral diarrhea in children younger than 5 years of age; it is a major cause of childhood morbidity and mortality.Objective:The aim of the study is todetermine the clinical picture, age distribution of patients with rotavirus infection and their maternal educational background.Patients &methods: A total of 202 patients suffering from diarrhea were included in this study, over 6 months period( from 1stof March 2011to 30th of August 2011),in Children Welfare Teaching hospital. History and physical examinationwere carried out, anthropometrics measures were done and plotted on Centers for Disease Control& World Health Organization charts to determine the nut
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