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.
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John Updike’s use of setting in his fiction has elicited different and even conflicting reactions from critics, varying from symbolic interpretations of setting to a sense of confusion at his use of time and place in his stories. The present study is an attempt at examining John Updike’s treatment of binary settings in Pigeon Feathers and Other Stories (1962) to reveal theme, characters’ motives and conflicts. Analyzing Updike’s stories from a structuralist’s perspective reveals his employment of two different places and times in the individual stories as a means of reflecting the psychological state of the characters, as in “The Persistence of Desire”, or expressing conflicting views on social and political is
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The aim of this study is to find a relationship between oxidative stress and adiponectin in Iraqi patients with acromegaly. The present study included 30 patients with acromegaly disease attending at Al-Yarmuk teaching hospital , and 30 healthy individuals as a control group.The two groups with ages ranging (30-55) years. The results revealed a highly significant elevation in all parameters (GH,IGF-1 , adiponectin , malondialdehyde , and peroxynitrite ) levels in sera of patients when compared with healthy control .It can be concluded that oxidative stress (malondialdehyde and peroxynitrite ) may be valuable in detecting of endocrine diseases like acromegaly .
The aim of this research is to construct a three-dimensional maritime transport model to transport nonhomogeneous goods (k) and different transport modes (v) from their sources (i) to their destinations (j), while limiting the optimum quantities v ijk x to be transported at the lowest possible cost v ijk c and time v ijk t using the heuristic algorithm, Transport problems have been widely studied in computer science and process research and are one of the main problems of transport problems that are usually used to reduce the cost or times of transport of goods with a number of sources and a number of destinations and by means of transport to meet the conditions of supply and demand. Transport models are a key tool in logistics an
... Show MoreThe cathodic deposition of zinc from simulated chloride wastewater was used to characterize the mass transport properties of a flow-by fixed bed electrochemical reactor composed of vertical stack of stainless steel nets, operated in batch-recycle mode. The electrochemical reactor employed potential value in such a way that the zinc reduction occurred under mass transport control. This potential was determined by hydrodynamic voltammetry using a borate/chloride solution as supporting electrolyte on stainless steel rotating disc electrode. The results indicate that mass transfer coefficient (Km) increases with increasing of flow rate (Q) where .The electrochemical reactor proved to be efficient in removing zinc and was abl
... Show MoreThe Character is one of the elements of Storytelling, as it is the center of the plot, making it the basis on which the talk is about. The talk is the portrayal of the character while they’re acting; the novelist presents the character by interacting with the events, and the extent of the negative and positive appearing impact on the character. It should be noted that everyone has two personalities or more, each one appearing in a different position or situation. For instance, a man can be a father, a lover, an employee, a son or anyone else .. in another position, he might be a master, and in another a looser begging for the mercy of his humiliator, and sometimes he can show weakness to the one he loves, or show strength to his enemie
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A new colorimetric-flow injection method has been developed and validated for the detection of Cefotaxime sodium in pharmaceutical formulations. This method stands out for its rapid and sensitive nature. The formation of a brown-colored complex between Cefotaxime sodium and the Biuret reagent in a highly alkaline environment serves as the basis for the detection. The intensity of this colored complex is measured using a custom-built Continuous Flow Injection Analyzer, enabling accurate quantification of Cefotaxime sodium. Optimization studies of the chemical and physical parameters such as dilution of Biuret reagent, effect of the medium basicity, flow rate, sample loop and others have been investigated. The calibration gra
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ABSTRACTBackground: In Iraq smoking is a common habit in both the urban and rural areas. There are many respiratory diseases like chronic bronchitis, bronchial carcinoma and emphysema which are related to chronic tobacco smoking.Objectives: To study the effect of tobacco smoking on the respiratory system, to establish a correlation between chronic tobacco smoking and its effects on the parameters which were studied and to create awareness in tobacco smokers about the effects of tobacco on their healthMethod: In this study 100 male subjects, 50 chronic smokers and 50 non- smokers were assessed for their pulmonary function tests by using a computerized spirometer.Results: Almost all their respiratory parameters were significantly reduced.
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