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 Love Creek Nature Center, one of the three nature centers located within the boundaries of Berrien County, is owned and operated by the county for public enjoyment and instruction of nature. The 44.5 ha study area, located seven km east of Berrien Springs, and two km southwest of Berrien Center, on Huckleberry Road, in T6S, R17W, sections 16, 17 (Lat. 41° 56' N; Long. 86° 18' W) is made up of deciduous woods and abandoned fields at various stages of succession. It is bounded on the east by the Berrien County Dog Pound and Huckleberry Road, to the north by cultivated Berrien County land and the Berrien General Hospital, to the west by the recently closed Berrien - Oronoko Township Landfill Dump; and to the south b
... Show MoreThis paper introduces a complete design and simulation of a controller for the double fed induction generator (DFIG) turbine. The work also included the solar updraft tower (SUT) design to supply Al-Mahmoudia hospital in Baghdad/Iraq. The design includes the daily average load estimation, annual solar irradiance and, temperature monitoring, and logging.
According to the data obtained from the Ministry of Science and Technology, Baghdad has low wind speed. Therefore, the (SUT) has been designed to generate electrical power depending on the difference between the external and internal air temperature. The temperature difference will generate a suitable airspeed to drive the wind turbine, connected to the proposed (DFIG) generators
... Show MoreBackground: Pain is one of the most reported side effects of orthodontic treatment despite the advanced technology in orthodontics. Many analgesics have been introduced to control orthodontic pain including acetaminophen and selective and nonselective nonsteroidal anti-inflammatory drugs. The great concern about these drugs is their adverse effect on rate of teeth movement. Aims: The purpose of this study was to evaluate and compare the effect of acetaminophen, ibuprofen and etoricoxib on pain perception and their influence on the rate of teeth movement during leveling and alignment stage. Methods: Forty patients were evenly and randomly distributed in a blinded way to one of four groups: placebo (starch capsules), acetaminophen 500mg th
... Show MoreNumerical study has been conducted to investigate the thermal performance enhancement of flat plate solar water collector by integrating the solar collector with metal foam blocks.The flow is assumed to be steady, incompressible and two dimensional in an inclined channel. The channel is provided with eight foam blocks manufactured form copper. The Brinkman-Forchheimer extended Darcy model is utilized to simulate the flow in the porous medium and the Navier-Stokes equation in the fluid region. The energy equation is used with local thermal equilibrium (LTE) assumption to simulate the thermofield inside the porous medium. The current investigation covers a range of solar radiation intensity at 09:00 AM, 12:00 PM, and 04:00
... Show MoreThe book The Laws of Duwan of Mamati's Son (T, 606 E) His approach to his narratives is a topic of historical and civilized importance. The Fatimid Age of the People of Jehovah has expanded its influence and authority, including ministers, writers, doughnuts and foreshores. One of the Christian families that shined in the late Fatmi era was "Mamati", who lived in "Assiut" from Upper Egypt, then moved to Cairo, and enrolled in the service of the Fatimids, where their sons held important positions in State offices.Ibn Mamati became in charge of the Army Office and then added to it the Finance Office, which became the most important downs in Egypt. Through his work in the Duwan Law Books, this book was a living record of the Dawawans in the Ay
... Show MoreExploring the antibacterial potential of neem oil (Azadirachta indica) in combination with gentamicin (GEN) against pathogenic molds, especially Pseudomonas aeruginosa, has drawn concern due to the quest for natural treatment options against incurable diseases. Prospective research directions include looking for natural cures for many of the currently incurable diseases available now. microbial identification system, were used to identify the isolates. The research utilized a range of methods, such as the diffusion agar well (AWD) assays, TEM (transmission electron microscopy) analysis, minimum inhibitory concentration (MIC) assays, and real-time PCR (RT-qPCR) to analyze bacterial expression and the antibacterial action of neem oil (Azadira
... Show MoreExtracorporeal shock wave lithotripsy (ESWL) is considered a standard treatment for nephrolith or kidney stones measuring less than 20 mm. Anatomical, machine-related, and stone factors play pivotal roles in treatment outcomes, the latter being the leading role. This paper examined the relationship between stone density on native CT scans and ESWL treatment to remove renal stones concerning several treatments. One hundred and twenty patients (64 males and 56 females) were enrolled and completed the study from April 2019 to September 2020. Inclusion criteria were a single renal pelvis stone of 5–20 mm to be treated for the first time in adult patients with no urinary or musculoskeletal anatomical abnormalities. We assessed patients
... Show MoreAdsorption of Chlorophenol compounds in aqueous solution on Iraqi siliceouns rocks powder have been investigated. UV technique has been used to determine the adsorption isotherms. The results showed that the adsorption isotherms obeyed Freundlich adsorption equation. The adsorption was endothermic process, increasing temperature leads to increasing adsorption. H, S, G were calculated. The results showed that the adsorption increases with increasing acidity of solutions