scholarly journals Open vs. Closed Sphincterotomy for Surgical Treatment of Anal Fissures

Author(s):  
Hisham Abdullah Almottowa ◽  
Hassan Hamdan Almohammadi ◽  
Hamzah Abdulaziz Alwehaimed ◽  
Osamah Salem Alsawat ◽  
Abdullah Sulaiman Alboseer ◽  
...  

There is currently no specific evidence regarding the exact etiology of anal fissures. However, various management options were reported and validated among the relevant research. Lateral internal sphincterotomy has been validated among relevant investigations in the literature as a valid modality for managing patients with chronic anal fissures. In the present literature review, we formulated evidence based on these studies to compare open and closed techniques of this surgery according to the reported outcomes. However, evidence regarding the superiority of either of the techniques over the other is not consistent among these investigations. For instance, some studies reported that closed sphincterotomy is more favorable than the open approach and should be considered the treatment choice for chronic anal fissures. This is because the technique is associated with less frequent rates of complications, less expensive, safe, and effective. On the other hand, many other relevant studies also demonstrated that the reported outcomes for the two modalities exhibited non-significant differences. Therefore, we suggest that researchers should furtherly conduct additional investigations before drawing any conclusions in this field.

Author(s):  
Debra Stark ◽  
Jessica Choplin ◽  
Sarah Wellard

Promoting the best interests of children and protecting their safety and well-being in the context of a divorce or parentage case where domestic violence has been alleged has become highly politicized and highly gendered. There are claims by fathers’ rights groups that mothers often falsely accuse fathers of domestic violence to alienate the fathers from their children and to improve their financial position. They also claim that children do better when fathers are equally involved in their children’s lives, but that judges favor mothers over fathers in custody cases. As a consequence, fathers’ rights groups have engaged in a nationwide effort to reform the custody laws to create a presumption of equal parenting time, with no exception when one of the parents has engaged in domestic violence. Domestic violence survivors and their advocates, however, claim that the needs of survivors of domestic violence and their children to be safe and free from further abuse are not being met in custody cases, that their claims of abuse are not being believed, and that the harm when a parent commits domestic violence against the other parent is not being recognized and addressed by judges and the family law professional upon whom they rely. This Article first presents a literature review, with articulated scientific standards applied to each of the pieces of research cited in this review, on what is happening outside of court and in court relating to domestic violence and best practices for taking domestic violence into account in these child custody cases. Among the key findings from this literature review are: (1) when a parent commits domestic violence against the other parent, this can cause serious long-term harm to children, (2) custody judgments tend to favor fathers over mothers because greater weight is placed on claims of alienation than on domestic violence claims, (3) long-term harms can be mitigated by evidence-based best practices, most notably, supporting non-abusive parents in their efforts to protect themselves and their children from further domestic violence, (4) family law judges and professionals must be trained on domestic violence and its nuances, as well as how to screen for domestic violence, to adequately support them, and (5) a component of this training is learning how to distinguish mutual “situational couple violence” for which “parallel parenting” custody arrangements might be feasible, from a pattern of “coercive abuse,” where sole decision-making and primary parenting time should be ordered to the non-abusive parent, and protective restrictions on parenting time should be ordered to the abusive parent. The Article then reports on a fifty-state review of custody-related laws (laws determining which parent makes major decisions relating to the child, who is allocated primary parenting time, and whether protective restrictions shall be placed on the parenting time of a parent who has engaged in domestic violence). This review found serious gaps between what evidence-based best practices suggest, and what is currently required by law in many states. These gaps in the law, including the failure of the law to require domestic violence screening and training for judges and other family law professionals, contribute to poor custody decision-making by them that compromises the safety and welfare of domestic violence survivors and their children. The Article then proposes nuanced law reforms that would align custody-related laws with evidence-based best practices for taking domestic violence into account in custody cases, including creating rebuttable presumptions, burdens of proof, and definitions of domestic violence that conform with these evidence-based best practices.


Author(s):  
Abdulwahid Mohammad Alghamdi ◽  
Noura Muhammed Alomrani ◽  
Ahmed Khaled Almarri ◽  
Mohammad Abdulghani Alqasimi ◽  
Faisal Khalid Qutah ◽  
...  

Evidence shows that erythema toxicum neonatorum (ETN) has been described in the literature since the 15th decade as a primarily rash in pediatric patients. Clinical studies show that the lesion of ETN is mainly characterized by the presence of minute yellowish papules and pustules that are usually surrounded by an irregular reddish wheal. It should be noted that evidence also demonstrated the pathology of these lesions is temporary and usually disappears within a few hours. In the present literature review, we discussed the etiology, prevalence, risk factors, and clinical signs of ETN based on findings from relevant research. The etiology of ETN is not clear among the different studies. However, some studies show involvement of immune and potential allergic reactions. The prevalence of the condition among infants is also remarkably variable among the relevant studies worldwide. There is also inconsistency in reporting the significance of the risk factors related to the prevalence and severity of the condition. On the other hand, the clinical signs among studies seem to be consistent and easily detected except when evaluating dark-skinned infants. Further studies are needed better to understand the etiology and epidemiology of the condition.


2019 ◽  
Vol 2 (1) ◽  
pp. 49-54
Author(s):  
Nicoleta Aurelia Sanda ◽  
Roxana Ristea ◽  
Ștefan Neagu

This paper aims to present the results of extensive studies on synchronous and metachronous tumors, both in order to optimize the surgical treatment of these, but also to concretize some suitable and useful screening measures for their early detection. The prognosis of cancer patients has improved over time. On the other hand, investigative methods have advanced considerably so that today are discovered tumors that could have gone unnoticed in the past. These data show why there are currently more cases of multiple cancers and their rate is steadily rising. The review will consider several studies focused on multiple tumors in terms of their localizations, manifestations, and risk factors. The first primary tumor found in a patient is called the index tumor, and the following tumors can be considered synchronous if they occurred in less than 6 months and metachronous if they occurred more than 6 months. Also, for the tumors of group IA, a variable of 4 centimeters was imposed13. Thus multiple tumors of the same tissue / organ (multicenter type A) are considered, tumors that are located at 4 cm or more of the index tumor, are histopathologically confirmed as malignant and are not metastasis or relapses of the first tumor.


2020 ◽  
Vol 146 (5) ◽  
pp. 1151-1164
Author(s):  
Hassan ElHawary ◽  
Kenzy Abdelhamid ◽  
Fanyi Meng ◽  
Jeffrey E. Janis

2007 ◽  
Vol 73 (12) ◽  
pp. 1218-1223
Author(s):  
Konstantinos E. Tsimogiannis ◽  
George K. Pappas-Gogos ◽  
Konstantinos Nikas ◽  
Stella Stefanaki-Nikou ◽  
Konstantinos Gossios ◽  
...  

Unresectable obstructing rectal cancer with synchronous hepatic metastases is usually a fatal disease. This prospective study was scheduled to treat this difficult condition using a multimodal curative strategy combined with a two-stage surgical treatment. Patients with T4N2 or N3M1 rectal cancer and hepatic metastases underwent a two-stage surgical treatment; in the first stage, a decompressing colostomy plus radiofrequency ablation (RFA) in liver metastases. In the second stage, a colectomy was done with stoma closing and resection of superficial necrotic hepatic tumors, plus repetition of RFA in recurrent or new hepatic tumors. Four patients were included, with 1 to 8 (total 20) hepatic metastases, each <5 cm in diameter. In the first stage, two patients were operated on by open approach and two laparoscopically. All hepatic tumors were treated by RFA to produce at least a 1-cm tumor-free margin. After chemoradiation of the rectal tumor, the second stage of surgical treatment was successful in colectomies and stoma closing. Three had complete necrosis of hepatic tumors and one a recurrent tumor plus two new metastases treated by RFA. Two patients died 14 and 42 months after the first stage of surgical treatment, and the other two patients are alive. One of them is disease-free 54 months after the first stage and the other with new recurrence 52 months after the first stage of the procedure. The multimodal curative strategy for the treatment of unresectable obstructing rectal cancer with synchronous hepatic metastases, containing a two-stage surgical treatment with RFA of hepatic metastases and chemoradiation of the rectal tumor between the two stages of the procedure, is a promising method. A larger number of patients with long-term follow-up is necessary to confirm these findings.


Author(s):  
Debi A. LaPlante ◽  
Heather M. Gray ◽  
Pat M. Williams ◽  
Sarah E. Nelson

Abstract. Aims: To discuss and review the latest research related to gambling expansion. Method: We completed a literature review and empirical comparison of peer reviewed findings related to gambling expansion and subsequent gambling-related changes among the population. Results: Although gambling expansion is associated with changes in gambling and gambling-related problems, empirical studies suggest that these effects are mixed and the available literature is limited. For example, the peer review literature suggests that most post-expansion gambling outcomes (i. e., 22 of 34 possible expansion outcomes; 64.7 %) indicate no observable change or a decrease in gambling outcomes, and a minority (i. e., 12 of 34 possible expansion outcomes; 35.3 %) indicate an increase in gambling outcomes. Conclusions: Empirical data related to gambling expansion suggests that its effects are more complex than frequently considered; however, evidence-based intervention might help prepare jurisdictions to deal with potential consequences. Jurisdictions can develop and evaluate responsible gambling programs to try to mitigate the impacts of expanded gambling.


Author(s):  
Sunandar Macpal ◽  
Fathianabilla Azhar

The aims of this paper is to explain the use of high heels as an agency for a woman's body. Agency context refers to pain in the body but pain is perceived as something positive. In this paper, the method used is a literature review by reviewing writings related to the use of high heels. The findings in this paper that women experience body image disturbance or anxiety because they feel themselves are not beautiful or not attractive. The use of high heels, makes women more attractive and more confident, on the other hand the use of high heels actually makes women feel pain and discomfort. However, for the achievement of beauty standards, women voluntarily allow their bodies to experience pain. However, the agency's willingness to beauty standards here is meaningless without filtering and directly accepted. Instead women keep negotiating with themselves so as to make a decision why use high heels.


2017 ◽  
Vol 1 (1) ◽  
pp. 90
Author(s):  
Dian Septiandani ◽  
Abd. Shomad

Zakat is one of principal worship requiring every individual (<em>mukallaf</em>) with considerable property to spend some of the wealth for zakat under several conditions applied within. On the other hand, tax is an obligation assigned to taxpayers and should be deposited into the state based on policies applied, with no direct return as reward, for financing the national general expense. In their development, both zakat and tax had quite attention from Islamic economic thought. Nevertheless, we, at first, wanted to identify the principles of zakat and tax at the time of Rasulullah SAW. Therefore, this study referred to normative research. The primary data was collected through library/document research and the secondary one was collected through literature review by inventorying and collecting textbooks and other documents related to the studied issue.


2020 ◽  
Author(s):  
Anaí Floriano Vasconcelos ◽  
Ademir Paceli Barbassa

Sustainable urban stormwater management (SUSM) is essential to urban sustainability. However, barriers to adopting it are observed even in places where SUSM is more widespread. Recent studies have evaluated strategies for overcoming some types of barriers. However, any study has systematically analyzed the strategies available for overcoming the most common barriers, contributing to widely adopting SUSM. Thus, this article aimed to provide a literature review on these strategies. Sixty-six documents were evaluated, resulting in eight solution strategies, detailed by 81 implementation measures, which were critically analyzed. The interrelationships among the solution strategies and their applicability to overcome the SUSM-related barriers were evaluated. This analysis showed that the solution strategies are interdependent, so it would be inefficient to adopt the strategies in isolation. On the other hand, adopting a strategy can help overcome several barriers, also enhancing other strategies, and consequently contributing to the global scenario of effective SUSM adoption. The availability of this systematized information helps break through common barriers and optimizing efforts to adopt SUSM where it is incipient.


Sign in / Sign up

Export Citation Format

Share Document