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.
In this article, a new deterministic primality test for Mersenne primes is presented. It also includes a comparative study between well-known primality tests in order to identify the best test. Moreover, new modifications are suggested in order to eliminate pseudoprimes. The study covers random primes such as Mersenne primes and Proth primes. Finally, these tests are arranged from the best to the worst according to strength, speed, and effectiveness based on the results obtained through programs prepared and operated by Mathematica, and the results are presented through tables and graphs.
Cover crops (CC) improve soil quality, including soil microbial enzymatic activities and soil chemical parameters. Scientific studies conducted in research centers have shown positive effects of CC on soil enzymatic activities; however, studies conducted in farmer fields are lacking in the literature. The objective of this study was to quantify CC effects on soil microbial enzymatic activities (β-glucosidase, β-glucosaminidase, fluorescein diacetate hydrolase, and dehydrogenase) under a corn (Zea mays L.)–soybean (Glycine max (L.) Merr.) rotation. The study was conducted in 2016 and 2018 in Chariton County, Missouri, where CC were first established in 2012. All tested soil enzyme levels were significantly different between 2016 and 2018
... Show MoreObjective: The goal of this research is to load Doxorubicin (DOX) on silver nanoparticles coupled with folic acid and test their anticancer properties against breast cancer. Methods: Chitosan-Capped silver nanoparticles (CS-AgNPs) were manufactured and loaded with folic acid as well as an anticancer drug, Doxorubicin, to form CS-AgNPs-DOX-FA conjugate. AFM, FTIR, and SEM techniques were used to characterize the samples. The produced multifunctional nano-formulation served as an intrinsic drug delivery system, allowing for effective loading and targeting of chemotherapeutics on the Breast cancer (AMJ 13) cell line. Flowcytometry was used to assess therapy efficacy by measuring apoptotic induction. Results: DOX and CS-Ag
... Show MoreThe mathematical construction of an ecological model with a prey-predator relationship was done. It presumed that the prey consisted of a stage structure of juveniles and adults. While the adult prey species had the power to fight off the predator, the predator, and juvenile prey worked together to hunt them. Additionally, the effect of the harvest was considered on the prey. All the solution’s properties were discussed. All potential equilibrium points' local stability was tested. The prerequisites for persistence were established. Global stability was investigated using Lyapunov methods. It was found that the system underwent a saddle-node bifurcation near the coexistence equilibrium point while exhibiting a transcritical bifurcation
... Show MoreThe corrosion inhibition effect of a new furan derivative (furan-2-ylmethyl sulfanyl acetic acid furan-2-ylmethylenehydrazide) on mild steel in 1.0 M HCl was investigated using corrosion potential (ECORR) and potentiodynamic polarization. The obtained results indicated that the new furan derivative (furan-2-ylmethyl sulfanyl acetic acid furan-2-ylmethylenehydrazide) (FSFD) has a promising inhibitive effects on the corrosion of mild steel in 1.0 M HCl across all of the conditions examined. The density functional theory (DFT) study was performed on the new furan derivative (FSFD) at the B3LYP/6-311G (d, p) basis set level to explore the relation between their inhibition efficiency and molecular electro
In the present work, a density functional theory (DFT) calculation to simulate reduced graphene oxide (rGO) hybrid with zinc oxide (ZnO) nanoparticle's sensitivity to NO2 gas is performed. In comparison with the experiment, DFT calculations give acceptable results to available bond lengths, lattice parameters, X-ray photoelectron spectroscopy (XPS), energy gaps, Gibbs free energy, enthalpy, entropy, etc. to ZnO, rGO, and ZnO/rGO hybrid. ZnO and rGO show n-type and p-type semiconductor behavior, respectively. The formed p-n heterojunction between rGO and ZnO is of the staggering gap type. Results show that rGO increases the sensitivity of ZnO to NO2 gas as they form a hybrid. ZnO/rGO hybrid has a higher number of vacancies that can b
... Show MoreThis research aims to removes dyes from waste water by adsorption using banana peels. The conduct experiment done by banana powder and banana gel to compare between them and find out which one is the most efficient in adsorption. Studying the effects different factors on adsorption material and calculate the best removal efficiency to get rid of the methylene blue dye (MB).
The aim of study was to explore pharmacist insights toward the impact of prospective implementation of the national health insurance program on patients, providers and Iraqi health system.
This was a qualitative study including semi-structured face-to-face (mostly) interviews with experienced pharmacists. The interview guide included open-ended questions about the impact of the national health insurance program on patients and healthcare providers at three levels: quality of services, costs, and frequency of visits. Potential challenges were also discussed. Interviews were conducted in four provinces from March to May 2022. Thematic analysis was used to analyze the interview findings and generate themes and subthemes.
The
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Here we determined the structure of a cold active family IV esterase (EstN7) cloned