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.
<p>The current work investigated the combustion efficiency of biodiesel engines under diverse ratios of compression (15.5, 16.5, 17.5, and 18.5) and different biodiesel fuels produced from apricot oil, papaya oil, sunflower oil, and tomato seed oil. The combustion process of the biodiesel fuel inside the engine was simulated utilizing ANSYS Fluent v16 (CFD). On AV1 diesel engines (Kirloskar), numerical simulations were conducted at 1500 rpm. The outcomes of the simulation demonstrated that increasing the compression ratio (CR) led to increased peak temperature and pressures in the combustion chamber, as well as elevated levels of CO<sub>2</sub> and NO mass fractions and decreased CO emission values un
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Background: The ultimate purpose of this prospective study is to estimate and measure swelling associated with surgical extrac¬tion of impacted mandibular third molars in different four post-operative times and to identify the risk factors associated with determination of their risk degree. Material and Methods: In this prospective cohort study 159 consecutive cases in which removal of impacted lower third molars in 107outpatients were evaluated. Five groups of variables have been studied which are regarded as a potential factor for swelling after mandibular third removal which will enable the surgeon to predict and counsel high risk patients in order to offer a preventive strategy. Results: Facial measurements were carried out on 1st, 2
... Show MoreThe study of services in villages is one of the imperative matters that must be focused on, because it leads to increased attention, which reduces the differences between the countryside and the urban. The extent of its.
It is well known that community services need to be reached by a person, unlike the anchor services that reach people, here the population distribution plays an important and prominent role in signing these services, so the dispersed distribution pattern and the gathering pattern appeared in the distribution, thus an effect on the time and distance that the person walked to obtain The services are community-based. Therefore
... Show MoreThe shoulder and hip joints though essentially both are ball and socket joints, show structural variability to serve functional needs.
This study aims at revealing some of the structural and functional properties of each of the two joints regarding the factors that contribute to the stability of any joint in the body, namely: bone, ligament, and muscle.
In this paper, chip and powder copper are used as reinforcing phase in polyester matrix to form composites. Mechanical properties such as flexural strength and impact test of polymer reinforcement copper (powder and chip) were done, the maximum flexural strength for the polymer reinforcement with copper (powder and chip) are (85.13 Mpa) and (50.08 Mpa) respectively was obtained, while the maximum observation energy of the impact test for the polymer reinforcement with copper (powder and chip) are (0.85 J) and (0.4 J) respectively
The kinetics of removing cadmium from aqueous solutions was studied using a bio-electrochemical reactor with a packed bed rotating cylindrical cathode. The effect of applied voltage, initial concentration of cadmium, cathode rotation speed, and pH on the reaction rate constant (k) was studied. The results showed that the cathodic deposition occurred under the control of mass transfer for all applied voltage values used in this research. Accordingly, the relationship between logarithmic concentration gradient with time can be represented by a first-order kinetic rate equation. It was found that the rate constant (k) depends on the applied voltage, the initial cadmium concentration, the pH and the rotational speed of cathode. It
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Generally fossil based fuels are used in internal combustion engines as an energy source.
Excessive use of fossil based fuels diminishes present reserves and increases the air pollution in
urban areas. This enhances the importance of the effective use of present reserves and/or to develop
new alternative fuels, which are environment friendly. Use of alternative fuel is a way of emission
control. The term “Alternative Gaseous Fuels” relates to a wide range of fuels that are in the
gaseous state at ambient conditions, whether when used on their own or as components of mixtures
with other fuels.
In this study, a single cylinder diesel engine was modified to use LPG in dual fuel mode to study
the performance, emis
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The synthesis of new benzodiazepine, imidazole, isatin, maleimide, pyrimidine and 1,2,4-triazole derived from 2-amino-4-hydroxy-1,3,5-triazine, via its cyclocondensation reaction with different organic reagents, is described. FT-IR, 1H-NMR and as well as 13C-NMR spectra disclosed the structures of the precursors and heterocyclic derivatives formed.
The open hole well log data (Resistivity, Sonic, and Gamma Ray) of well X in Euphrates subzone within the Mesopotamian basin are applied to detect the total organic carbon (TOC) of Zubair Formation in the south part of Iraq. The mathematical interpretation of the logs parameters helped in detecting the TOC and source rock productivity. As well, the quantitative interpretation of the logs data leads to assigning to the organic content and source rock intervals identification. The reactions of logs in relation to the increasing of TOC can be detected through logs parameters. By this way, the TOC can be predicted with an increase in gamma-ray, sonic, neutron, and resistivity, as well as a decrease in the density log
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Abstract:
The research sought to identify the crises that occurred during the research period and their reflection on the performance of the hotel Research sample as well as to identify the reality of auditing the hotel Research sample and the preparation of a performance audit program can be adopted in auditing the performance of hotels in light of crises, and the problem of the research lies in the lack of a program to audit the performance of hotels that takes into account the crises experienced by the hotel sector, The research was based on solving its problems on three hypotheses, the first is that the performance audit in light of the Covid-19 pand
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