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 surgeryKeywords: Non-surgical treatment of anal fissure, fissure in ano, sphicterotomy,botulinum toxin in anal fissures, glyceryl trinitrate. Chemical sphincteratomy, pharmacological sphincteratomy.
The population has been trying to use clean energy instead of combustion. The choice was to use liquefied petroleum gas (LPG) for domestic use, especially for cooking due to its advantages as a light gas, a lower cost, and clean energy. Residential complexes are supplied with liquefied petroleum gas for each housing unit, transported by pipes from LPG tanks to the equipment. This research aims to simulate the design and performance design of the LPG system in the building that is applied to a residential complex in Baghdad taken as a study case with eight buildings. The building has 11 floors, and each floor has four apartments. The design in this study has been done in two parts, part one is the design of an LPG system for one building, an
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A simple and novel membraneless paper-based microfluidic fuel cell was presented in this study. The occurrence of laminar flow was employed to ensure no mixing of the fuel and oxidant fluids along the bath of reaction. The acidic wastewater was used as a fuel. It was an air-breathing cell, so air and tab water were used as oxidants. Both the fuel and tab water flowed continuously under gravity. Whatman filter paper was used for preparation of the fuel cell channel and two carbon fibre electrodes were used and firmed on the edges of the cell. The performance of the cell was examined over three consecutive days. The results indicated that the present cell has the potential to generate electric power, but an extensive study is required to harv
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A simple, accurate, precise, rapid, economical and a high sensitive spectrophotometric method has been developed for the determination of tadalafil in pharmaceutical preparations and industrial wastewater samples, which shows a maximum absorbance at 204 nm in 1:1 ethanol-water. Beer's law was obeyed in the range of 1-7?g/ mL ,with molar absorptivity and Sandell ? s sensitivity of 0.783x105l/mol.cm and 4.97 ng/cm2respectively, relative standard deviation of the method was less than 1.7%, and accuracy (average recovery %) was 100 ± 0. 13. The limits of detection and quantitation are 0.18 and 0.54 µg .ml-1, respectively. The method was successfully applied to the determination of tadalafil in some pharmaceutical formulations
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Retained soft tissue foreign bodies following injuries are frequently seen in the Emergency and Plastic Surgery practice. The patients with such presentations require a watchful and detailed clinical as- sessment to overcome the anticipant possibility of missing them. However, the diagnosis based on the clinical evaluation is usually challenging and needs to be supported by imaging modalities that are suboptimal and may fail in identifying some types of foreign bodies. Owing to that, serious complications such as chronic pain, infection, and delayed wound healing can be faced that necessitate a prompt intervention to halt those detrimental consequences. The classical method of removal is a surgical exploration which is not free of risks.
... Show Moreالخلفية: العقدية المقيحة المعروفة أيضًا باسم ""(GAS) هي احدى مسببات الأمراض ذات الأهمية الصحية العامة، حيث تصيب 18.1 مليون شخص في جميع أنحاء العالم وتقتل 500000 شخص كل عام. الهدف: حددت هذه المراجعة المقالات المنشورة حول عوامل الخطر واستراتيجيات الوقاية والسيطرة لأمراض المكورات العقدية. المواد والأساليب: تم إجراء بحث منهجي لتحديد الأوراق المنشورة على قواعد البيانات الإلكترونية Web of Science و PubMed و Scopus و Google Scholar في مح
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Computations of the relative permeability curves were made through their representation by two functions for wetting and nonwetting phases. Each function contains one parameter that controls the shape of the relative permeability curves. The values of these parameters are chosen to minimize an objective function, that is represented as a weighted sum of the squared differences between experimentally measured data and the corresponding data calculated by a mathematical model simulating the experiment. These data comprise the pressure drop across core samples and the recovery response of the displacing phase. Two mathematical models are constructed in this study to simulate incompressible, one-dimensional, two-phase flow. The first model d
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