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.
Background: While warfarin and direct oral anticoagulants (DOACs) are used to manage thromboembolic events, they possess several features that impact adherence. Objective: To assess medication adherence and self-efficacy in patients receiving warfarin or DOAC treatment. Methods: A cross-sectional study was performed at Ibn Al-Bitar Hospital in Baghdad from December 2022 to May 2023 on patients receiving either warfarin or DOACs. The Arabic version of the Adherence to Refills and Medications Scale (ARMS) questionnaire and the Self-Efficacy for Managing Chronic Disease 6-Item Scale (SES6C) questionnaire were used to assess adherence and self-efficacy. Results: 181 patients were enrolled in the study, of whom 56.9% received warfarin an
... Show MoreIn this study, the new azo dye,5,5-[1,2-phenylenebis(2,1-biazenediyl)] bis[8-quinolino], was used to synthesize complexes with Co2+, Ni2+, Cu2+, Zn2+, and Cd2+ ions. The compounds were characterized using 1H and 13C nuclear magnetic resonance (NMR) spectroscopy, Fourier transform infrared (FT-IR) spectroscopy, ultraviolet-visible (UV-Vis) spectroscopy, mass spectrometry, thermo gravimetric analysis (TGA), diffevential scanning calovimltry (DSC), CHN analysis. Further, conductivity, magnetic susceptibility, and metal and chlorine content analysis using FT-IR spectroscopy revealed that the ligand chelates as a bidentate (OH) phenol group and a bidentate (C=N) ring group. The ligand exhibited tetradentate behavior, forming tetrahedral complexe
... Show MoreIn the present work, bentonite clay was used as an adsorbent for the removal of a new prepared mono azo dye, 4-[6-bromo benzothiazolyl azo] thymol (BTAT) using batch adsorption method. The effect of many factors like adsorption time, adsorbent weight, initial BTAT concentration and temperature has been studied. The equilibrium adsorption data was described using Langmuir and frundlich adsorption isotherm. Based on kinetics study, it was found that the adsorption process follow pseudo second order kinetics. Thermodynamics data such as Gibbes Free energy ∆Gᵒ, entropy ∆Sᵒ and ∆Hᵒ were also determined using Vant Hoff plot.
In this paper the concept of (m, n)- fully stable Banach Algebra-module relative to ideal (F − (m, n) − S − B − A-module relative to ideal) is introducing, we study some properties of F − (m, n) − S − B − A-module relative to ideal and another characterization is given
This paper presents the syntactic dimension of ditransitive verbs in terms of the universal theory of Role and Reference Grammar (RRG). This theory is syntactic in nature, but it also covers the semantic as well as the pragmatic aspects of any linguistic phenomenon. It assumes a universal framework through which syntactic constructions can be analyzed. However, the morphological structure that each language enjoys renders the universal treatment more complicated and can question the universal nature of such a theory. In this paper, an attempt is made to check if the universal tenet of the theory is maintained over two typologically different languages: English and Arabic in respect of the way that double-object constructions (DOCs)
... Show MoreABSTRACT Background: Dental caries is a most common social and intractable infectious disease in human. Saliva is critical for preserving and maintaining oral health and salivary elements had many effects on caries experience. Aim of study: This study was conducted to assess dental caries severity by age and gender and their relation to salivary zinc and copper among a group of adults aged (19-22) years. Materials and methods: After examination eighty persons aged 19-22 years of both gender. Caries severity was documented according to DMFS index. Stimulated salivary samples were collected and chemically analyzed under standardized condition to detect salivary elements zinc and copper. Concentrations of Zinc and copper were measured by using
... Show MoreThis paper aims to study the effect of circular Y-shaped fin arrangement to improve the low thermal response rates of a double-tube heat exchanger containing Paraffin phase change material (PCM). ANSYS software is employed to perform the computational fluid dynamic (CFD) simulations of the heat exchanger, including fluid flow, heat transfer, and the phase change process. The optimum state of the fin configuration is derived through sensitivity analysis by evaluating the geometrical parameters of the Y-shaped fin. For the same height of the fins (10 mm), the solidification time is reduced by almost 22%, and the discharging rate is enhanced by almost 26% using Y-shaped fins compared with the straight fins. The results demonstrate that the sol
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This research aims to study human error effects in the banking risks in the private banks through the measurement and testing of human error effect in every kind of banking risks types and stand on the most closely associated with the risks in order to focus on them and make appropriate processors have with respect to and increase the availability of skills and expertise required to carry out banking operations of error-free manner.
Find dealt with human error in terms of meaning and understandable, classifications and types, causes and consequences and its approaches and theories. Also addressed placed banking risks in terms of meaning and concept, species and entr
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