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 study objectives were to (1) describe the characteristics of the pharmacy professionals and (2) explore the association between job satisfaction and factors, such as work control, work stress, workload and organization and professional commitments.
This study was a cross-sectional design. The survey items were mainly adapted from the US National Pharmacist Workforce Survey. An electronic (Qualtrics) questionnaire was posted on pharmacist social media in several A
Utilizing phase change materials in thermal energy storage systems is commonly considered as an alternative solution for the effective use of energy. This study presents numerical simulations of the charging process for a multitube latent heat thermal energy storage system. A thermal energy storage model, consisting of five tubes of heat transfer fluids, was investigated using Rubitherm phase change material (RT35) as the. The locations of the tubes were optimized by applying the Taguchi method. The thermal behavior of the unit was evaluated by considering the liquid fraction graphs, streamlines, and isotherm contours. The numerical model was first verified compared with existed experimental data from the literature. The outcomes re
... Show MoreThe rapid advancements in wireless technology and digital electronics have led to the widespread adoption of compact, intelligent devices in various aspects of daily life. These advanced systems possess the capability to sense environmental changes, process data, and communicate seamlessly within interconnected networks. Typically, such devices integrate low-power radio transmitters and multiple smart sensors, hence enabling efficient functionality across wide ranges of applications. Alongside these technological developments, the concept of the IoT has emerged as a transformative paradigm, facilitating the interconnection of uniquely identifiable devices through internet-based networks. This paper aims to provide a comprehensive ex
... Show MoreThe rapid increase in the number of older people with Alzheimer's disease (AD) and other forms of dementia represents one of the major challenges to the health and social care systems. Early detection of AD makes it possible for patients to access appropriate services and to benefit from new treatments and therapies, as and when they become available. The onset of AD starts many years before the clinical symptoms become clear. A biomarker that can measure the brain changes in this period would be useful for early diagnosis of AD. Potentially, the electroencephalogram (EEG) can play a valuable role in early detection of AD. Damage in the brain due to AD leads to changes in the information processing activity of the brain and the EEG which ca
... Show Morethis paper contains preparation of Active carbon surface (AC) from pro so millet grain husks and Loading and activating by Iron oxide and hydrogen peroxide sequentially to obtain surface (ACIPE). The changes of previous processes on Active carbon surface were diagnosed by Fourier transform infrared spectroscopy (FTIR) and Scanning electron microscopy ( SEM ). These surfaces (AC and ACIPE ) were using as adsorbent for removing of congo red dye from aqueous solutions under certain conditions through batch system. More than one kinetic model was applied to congo red dye adsorption process and it was found that the most kinetic model applied to it is a model ( pseudo second order model).
The current study was conducted in the environment of the Martyr Monument Lake in the city center of Baghdad during 2019 to monitor the impact of climatic conditions such as drought, water shortage, high temperatures in the environment of the city and the lack of water flow during the years 2015 to 2018 and their effects on some of the physical and chemical factors of water and the dynamics of the phytoplankton community in the lake environment. Heterogeneity of some studied environmental factors, including air and water temperature, permeability, water depth, pH, DO, BOD5, nutrients, nitrate, NO3, and phosphates were found. The results showed the effect of climate change and the pres
Green synthesis methods have emerged as favorable techniques for the synthesis of nano-oxides due to their simplicity, cost-effectiveness, eco-friendliness, and non-toxicity. In this study, Nickel oxide nanoparticles (NiO-NPs) were synthesized using the aqueous extract of Laurus nobilis leaves as a natural capping agent. The synthesized NiO-NPs were employed as an adsorbent for the removal of Biebrich Scarlet (BS) dye from aqueous solution using adsorption technique. Comprehensive characterization of NiO-NPs was performed using various techniques such as atomic force microscopy (AFM), Fourier transform infrared (FTIR), X-ray diffraction (XRD), Brunauer-Emmett and Teller (BET) analysis, and scanning electron microscopy (SEM). Additionally, o
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Background: The aims of this study were to evaluate the effect of implant site preparation in low-density bone using osseodensification method in terms of implant stability changes during the osseous healing period and peri-implant bone density using CBCT. Material and methods: This prospective observational clinical study included 24 patients who received 46 dental implants that were installed in low-density bone using the osseodensification method. CBCT was used to measure the bone density pre- and postoperatively and implant stability was measured using Periotest® immediately after implant insertion and then after 6 weeks and 12 weeks postoperatively. The data were analyzed using paired t-test and the probability value <0.05 was conside
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