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 surgery Keywords: Non-surgical treatment of anal fissure, fissure in ano, sphicterotomy,botulinum toxin in anal fissures, glyceryl trinitrate. Chemical sphincteratomy, pharmacological sphincteratomy.
Phenol condensed with β-keto esters via Pechmann condensation to form derivatives of Coumarin in various reaction conditions by two ways. Present paper is comparative study of synthesis Coumarin with the yield of product , reaction time and reaction conditions.
Drought is a natural phenomenon in many arid, semi-arid, or wet regions. This showed that no region worldwide is excluded from the occurrence of drought. Extreme droughts were caused by global weather warming and climate change. Therefore, it is essential to review the studies conducted on drought to use the recommendations made by the researchers on drought. The drought was classified into meteorological, agricultural, hydrological, and economic-social. In addition, researchers described the severity of the drought by using various indices which required different input data. The indices used by various researchers were the Joint Deficit Index (JDI), Effective Drought Index (EDI), Streamflow Drought Index (SDI), Sta
... Show MoreCorona virus sickness has become a big public health issue in 2019. Because of its contact-transparent characteristics, it is rapidly spreading. The use of a face mask is among the most efficient methods for preventing the transmission of the Covid-19 virus. Wearing the face mask alone can cut the chance of catching the virus by over 70\%. Consequently, World Health Organization (WHO) advised wearing masks in crowded places as precautionary measures. Because of the incorrect use of facial masks, illnesses have spread rapidly in some locations. To solve this challenge, we needed a reliable mask monitoring system. Numerous government entities are attempting to make wearing a face mask mandatory; this process can be facilitated by using face m
... Show MoreThe occurrences of invasive candidiasis has increased over the previous few decades. Although Candida albicans considers as one of the most common species of organisms, that cause acquired fungal infections. Candida albicans is an opportunistic fungal pathogen and inherent in as a lifelong, the yeast is present in healthy individuals as a commensal, and can reside harmlessly in human body. However, in immuno-compromised individuals, the fungus can invade tissues, producing superficial infections and, in severe cases, life-threatening systemic infections. This review wills emphasis on virulence factor of C. albicans including (adhesion, invasion, candida proteinase, and phenotypic switching and biofilm formation. I
... Show MoreConstruction projects are characterized as projects with multi phases and activities, complex, unique, and have many different parties and stakeholders. Risks could appear at one or more of the construction project stages and may affect the achievement of project objectives. Therefore, one of the key elements in the planning phase of any project is the risk management process (RMP). This study attempts to understand the terminology of risk in general, risk management, and response to risk in particular. This study is mainly a review of thirty-eight studies that have been published between 1997 and 2020 that demonstrate the importance of the crucial phase of risk response from the risk management process and its impact on
... Show MoreThe seizure epilepsy is risky because it happens randomly and leads to death in some cases. The standard epileptic seizures monitoring system involves video/EEG (electro-encephalography), which bothers the patient, as EEG electrodes are attached to the patient’s head.
Seriously, helping or alerting the patient before the seizure is one of the issue that attracts the researchers and designers attention. So that there are spectrums of portable seizure detection systems available in markets which are based on non-EEG signal.
The aim of this article is to provide a literature survey for the latest articles that cover many issues in the field of designing portable real-time seizure detection that includes the use of multiple
... Show MoreThe lack of active 2019 coronavirus disease (COVID-19) pandemic treatment creates a challenge for researchers and scientists to find the most appropriate treatment for this disease. Dexamethasone, according to the findings of the RECOVERY clinical trial, declared mid-June 2020 in print media was one of those therapies. Although the results from retrospective studies are not strongly supportive of corticosteroid routine use in COVID-19 despite the signals for some benefits, the dedicated RECOVERY trial found a significant reduction in death with dexamethasone only in severe cases on a ventilator or moderate cases on supplemental oxygen therapy nevertheless, no benefit observed in mild to moderate cases requiring no oxygen. More studi
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