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 challenge to incorporate usability evaluation values and practices into agile development process is not only persisting but also systemic. Notable contributions of researchers have attempted to isolate and close the gaps between both fields, with the aim of developing usable software. Due to the current absence of a reference model that specifies where and how usability activities need to be considered in the agile development process. This paper proposes a model for identifying appropriate usability evaluation methods alongside the agile development process. By using this model, the development team can apply usability evaluations at the right time at the right place to get the necessary feedback from the end-user. Verificatio
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Background:This is a prospective study of three children presented to us in the Orbital clinic in AL ShahidGazi Al Hariri Hospital with painless proptosiswith suspension of Hydatid disease.Objectives: : Orbital hydatid disease is a rare lesion accounting for less than 1% of the total lesions of the body (1, 2). Orbital cysts presented as a primary lesion in our study which is rare to have such lesion without involvement of other organs (3). Humans represent the intermediate host where the commonly affected organ are liver and the lung (10-15%) (4). Methods:This is a prospective study of three Children presented to us in the Orbital clinic in Al Shahid Ghazi Alhariri Hospital with painless proptosis with suspension of Hydatid disease, dep
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The pressures of life have become a tangible phenomenon in all societies in varying degrees. This disparity determines several factors, including the nature of societies, the level of their urbanization, the intensity of interaction, the intensity of conflict, and the increasing rate of change in those societies. many people name The modern era in which we live the “era of pressures", where one of the most important of these changes is the “new Coronavirus 19-COVID”, which has spread widely throughout the world, as the pandemic, has affected all aspects of daily life, including the educational and academic process, academic activities have been suspended in universities, which caused sudden change
... 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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A study of taxonomic quality of soil algae was conducted with some environmental variables in three sites of local gardens (Kadhimiya, Adhamiya and Dora) within the governorate of Baghdad for the period from October 2016 to March 2017. The study identified 28 species belonging to 16 species in which the predominance of blue green algae (18 species) Followed by Bacillarophyta algae (7 species) and three types of Chlorophyta. The study showed an increase in species of Oscillatoria. The results showed no significant differences between sites in temperature, pH and relative humidity, while there were clear differences between sites for salinity and nutrient The study showed a difference of irrigation water quality and use of different fertilize
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This work provides a historical overview of water storage tanks used for solar energy collection, with a focus on the impact of different geometric configurations on thermal performance and energy storage efficiency. The designs of cylindrical, spherical, rectangular and triangular tanks were reviewed to analyse their effects on thermal gradients, heat retention and energy storage capacity. Within the scope of nominal processes, the study primarily aimed to identify the factors influencing the choice of tank shape in terms of size, capacity and aspect ratio. Another key objective was to assess what enhances heat storage in the tank to improve thermal efficiency. Comparing cylindrical shapes to other shapes, such as spherical, rectan
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