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.
There is no doubt that teachers are the leaders of positive changing in community where they directed the students and build their brains. In our current generation that characterized by accelerated technological development that communication changes, economic and politics, needs from the teacher an active leadership skills that match with the soul of our generation and contribute in confrontation the current challenges and the future challenges in the form that lead to create a conscious generation where they will be a basic brick for the future community where the listeners looking forward the education where they support the continuity communication of develop process, economy, scientifically and in all life fields. In our study we take
... Show MoreAn essential tool for studying the web is its ability to show how energy moves through an ecosystem. Understanding and elucidating the relationship between species variety and their placement within the inclusive trophic dynamics is also beneficial. A food web ecological model with prey and two rival predators under fear and wind flow conditions is developed in this article. The boundedness and positivity of the system’s solution are established mathematically. The stability and existence constraints of the system’s equilibria are examined. The proposed system’s persistence limitations are established. Additionally, the bifurcation analysis of every potential equilibrium is examined using the Sotomayor theorem. To describe the
... Show MoreThis research deals with the qualitative and quantitative interpretation of Bouguer gravity anomaly data for a region located to the SW of Qa’im City within Anbar province by using 2D- mapping methods. The gravity residual field obtained graphically by subtracting the Regional Gravity values from the values of the total Bouguer anomaly. The residual gravity field processed in order to reduce noise by applying the gradient operator and 1st directional derivatives filtering. This was helpful in assigning the locations of sudden variation in Gravity values. Such variations may be produced by subsurface faults, fractures, cavities or subsurface facies lateral variations limits. A major fault was predicted to extend with the direction NE-
... Show MoreThis article deals with the impact of including transverse ribs within the absorber tube of the concentrated linear Fresnel collector (CLFRC) system with a secondary compound parabolic collector (CPC) on thermal and flow performance coefficients. The enhancement rates of heat transfer due to varying governing parameters were compared and analyzed parametrically at Reynolds numbers in the range 5,000–13,000, employing water as the heat transfer fluid. Simulations were performed to solve the governing equations using the finite volume method (FVM) under various boundary conditions. For all Reynolds numbers, the average Nusselt number in the circular tube in the CLFRC system with ribs was found to be larger than that of the plain abs
... Show MorePiperine, a crystalline alkaloid compound isolated from Piper nigrum, piper longum, and other types of piper, has had many fabulous pharmacological advantages for preventing and treating some specific diseases, such as analgesic, anti-inflammatory, hepatoprotective, antimetastatic, antithyroid, immunomodulatory, antitumor, rheumatoid arthritis, osteoarthritis, Alzheimer's, and improving the bioavailability of other drugs. However, its potential for clinical use through oral usage is hindered by water solubility and poor bioavailability. The low level of oral bioavailability is caused by low solubility in water and is photosensitive, susceptible to isomerization by UV light, which causes piperine concentration to decrease. Many different
... Show MoreIn this work, synthesis of conducting polymeric films namely, PVC thin films was carried out containing Schiff base (L) with Cu2+, Cr3+, Ni2+, Co2+, in addition to inspecting the possibilities of measuring energy gap values of PVC-L-M with variety metal ions. These new polymeric films (PVC-L-M) were characterized by FTIR spectrophotometry, energy gap and surface morphology. The optical data recorded that the band gap values are influenced by the type of metals. All modified films have a red shift in optical properties in the ultraviolet region. The PVC-L-Co(II) was the lowest value of the optical band gap, 3.1 eV.
One of the main element in the network is the intersection which consider as the critical points because there are many conflict in this element. The capability and quality of operation of an intersection was assessed to provide a better understanding of the network's traffic efficiency. In Baghdad city, the capital of/Iraq the majority of the intersections are operated under the congestion status and with level of service F, therefore theses intersection are consider as high spot point of delay in the network of Baghdad city. In this study we selected Al-Ameria signalized intersection as a case study to represent the delay problem in the intersections in Baghdad. The intersection is located in the w