Botulinum Toxin Treatment for Anal Fissure

Objectives: To evaluate the effectiveness of Botulinum toxin injection in the treatment of anal fissure. Methods: 38 patients (22 males; 16 females; mean age (SD) of 33.3 (8.3) years) who have presented to Surgical Outpatient Clinic at Al Ain Hospital; United Arab Emirates; with anal fissure in the period between June 2000 and September 2001 and treated with Botulinum toxin injection were retrospectively studied. They were followed up for at least 8 weeks to evaluate the effects of treatment. Results: Treatment with Botulinum toxin was effective in 89of patients with chronic uncomplicated anal fissure. Two patients experienced minor incontinence in the form of a fecal soiling which disappeared later. Conclusion: Botulinum toxin injection is an effective alternative for surgery for treatment of uncomplicated idiopathic anal fissure. Surgery should be offered to patients who do not improve with Botulinum toxin injection and to those with complicated anal fissure

impact of four wheel drives on road traffic disability and deaths compared to passenger cars

The aim of this study was to examine the pattern of injuries resulting from road traffic crashes involving four wheel drives [4WD] vehicles and passenger cars in the United Arab Emirates [UAE]. Descriptive study. Al-Ain and Tawam Hospital, UAE, during a period from 1st January to 31st December 2000. A questionnaire was created and filled out concerning: sociodemographic information; data about driving behavior and attitude which included driving experience, adherence to traffic laws [including speed limits and wearing seat belt], driving habits, and assessment of sustained injury was performed according to the Abbreviated Injury Score [AIS]. A total of 1157 motor vehicle crashes related casualty patients were hospitalized during the year 2000. Of these total patients, 495 victims [42.8%] were involved with 4WDs road traffic crashes related injuries and 72.9% of them required hospitalization. Of these, 76.8% were males, 60.7% were non-UAE nationals. The head injury was more common in those who had crashes from 4WD vehicles [45.6%] than those who had crashes from small cars [37.3%]. Abbreviated injury scare showed that four wheelers caused more severe [9.1%], serious [10.3%], critical [8.3%] and moderate injuries [13.9%]. A significant higher risk was observed for speed violations [OR=2.06; 95% CI=1.55-2.76, p<0.001]; property damage [OR=1.54; 95% CI=1.07-2.22, p<0.014] and pedestrian accident [OR=2.09; 95% CI=1.46-2.99, p<0.001]. The present study findings indicated that nearly half of the road traffic crashes were involved with 4WD vehicles and that most of the injured individuals were pedestrian and younger drivers. Reduction in motor vehicle injuries and deaths represents a major public health success