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.
Alizarin is one of the popularly used and wide separated compounds with a chemical name (1,2- dihydroxy-9,10-anthraquinone) which belong to the anthraquinones family that contain three aromatic conjugated rings and in the central rings it contains two ketonic groups.1
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Rivers Tigris and Euphrates, as well as the wetlands in southern Iraq and the Diyala River, were all included in the evaluation of earlier studies on the variety and factors impacting fish in Iraqi waters. Different studies documented different types, and the number of species recorded varied between the studies, which could be explained by the registration of some species, synonyms, differs from the registration of some species with synonymous names By mistake, as well as recording new species in times that followed some previous studies, Also, the difference in some factors, including the pollution of some waterways, leads to a difference in the existing species, so we find the presence of species that are tolerant of pollution. There are
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This review discusses precision agriculture techniques that help reduce the effects of soil degradation and improve soil health, based on an analysis of studies published in scientific databases such as Web of Science, Scopus, IEEE Xplore, Google Scholar, and ScienceDirect, with an emphasis on recent field research. The methodology included a qualitative analysis of case studies and application experiments in different areas to evaluate the impact of technologies such as controlled traffic farming (CTF), mechanized guidance (MG), precision fertilization (PF), precision irrigation (PI), conservation tillage (CT), and precision tillage (PT). Research results showed, CT to maintain soil structure and reduce organic matter loss increases soil f
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The impact of management control systems (MCS) on organizations performance empirical research has been the subject of numerous studies during the past decade in developed and emerging economies. In the contemporary competitive, complex and changing global business environment, firms are being challenged to adopt business models that enable them to address the strategic uncertainties and risks they face in their business environments. The main issue of this study is that management accounting researchers argue that one of the ways firms can continually rejuvenate themselves to survive and succeed in these complex and uncertain environments is to understand the role of management control systems in Formulating a b
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Abstract: Plastic pollution is a major issue of the current century. This waste is found in seas, freshwater, lakes, rivers, coastal areas, and soil. In this article, this article discusses the various sources of plastic pollution, including the manufacturing process of plastics and the addition of materials to improve their properties, as well as the use of single-use plastics that are not recyclable, in addition to burning and illegal waste disposal in the open. The impact on public health is through human exposure to toxins from plastics in the environment directly through inhaling dust and fumes, consuming contaminated food and drink, and skin contact. Indirectly, when marine creatures consume microplastics, they will find their way
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