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.
A simple, environmental friendly and selective sample preparation technique employing porous membrane protected micro-solid phase extraction (μ-SPE) loaded with molecularly imprinted polymer (MIP) for the determination of ochratoxin A (OTA) is described. After the extraction, the analyte was desorbed using ultrasonication and was analyzed using high performance liquid chromatography. Under the optimized conditions, the detection limits of OTA for coffee, grape juice and urine were 0.06 ng g−1, 0.02 and 0.02 ng mL−1, respectively while the quantification limits were 0.19 ng g−1, 0.06 and 0.08 ng mL−1, respectively. The recoveries of OTA from coffee spiked at 1, 25 and 50 ng g−1, grape juice and urine samples at 1, 25 and 50 ng mL
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A simple setup of random number generator is proposed. The random number generation is based on the shot-noise fluctuations in a p-i-n photodiode. These fluctuations that are defined as shot noise are based on a stationary random process whose statistical properties reflect Poisson statistics associated with photon streams. It has its origin in the quantum nature of light and it is related to vacuum fluctuations. Two photodiodes were used and their shot noise fluctuations were subtracted. The difference was applied to a comparator to obtain the random sequence.
Background: Rheumatoid arthritis (RA) is a chronic and systemic autoimmune disease that is characterized by severe synovial inflammation, cartilage erosion, bone loss, and generalized vasculopathy. Although the immunologic mechanism of RA is still unclear, it is now thought to be a primarily Th17-driven disease. Along with other factors, IL-23 stimulates the expansion of Th17 cells from naive CD4+ T cells.
Objective: The objective of this study is to assess the circulating levels of interleukin (IL)-23 in rheumatoid arthritis (RA) and determine the correlation between plasma/serum IL-23 levels and disease activity. So, we performed a systematic review with meta-analysis comparing
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The paper sheds light on the meanings of colours as a significant medium reflecting the world linguistic image which represents the culture of any country since language is closely related with culture. Language goes hand in hand with people's daily expressions, specifically those cultural ones. Language is a way to store historical and cultural information, and is a means of transferring the experience of a group to outside groups.
The world linguistic image identifies the standards of human behavior in dependence upon the human view of the surrounding world, along with the type of behavior with which the world interacts and to whose challenges and effects it responds. So, multi-cultural people perceive the sam
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A 3D Geological model was generated using an advanced geostatistical method for the Cretaceous reservoir in the Bai Hassan oil field. In this study, a 3D geological model was built based on data from four wells for the petrophysical property distribution of permeability, porosity, water saturation, and NTG by using Petrel 2021 software. The geological model was divided into a structural model and a property model. The geological structures of the cretaceous reservoir in the Bai Hassan oil field represent elongated anticline folds with two faults, which had been clarified in the 3D Structural model. Thirteen formations represent the Cretaceous reservoir which includes (Shiranish, Mashurah, U.kometan, Kometan Shale, L. Kometan, Gulnen
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Based on the assumption that the more teachers know about brain science, the better
prepared they will be to make instructional decisions.
Mind Mapping is a powerful tool for assisting any form of writing. Language is an
important device and a very beneficial means for human being to communicate with other
people .Writing is one of the language skills that will never be left in education.
The study aims at investigating the Impact of applying mind mapping technique as a prewriting
tool on Iraqi EFL college students in essay writing. To do so, 60 EFL college students
were divided randomly selected and divided into two groups experimental and control. Prior
to treatment, participants of the both groups were given a
Background: Type 2 diabetes mellitusand chronic periodontitis hold a close relationship that has been the focus of many researches. Currently there is an appreciation to the role of adipose tissue-derived substances "the adipokines" in immune-inflammatory responses; also, there is an interest in using the simple non-invasive saliva in diagnosing and linking oral and general health problems. The current study aims to determine the periodontal health status in the chronic periodontitis patients with and without poorly or well controlled type 2 diabetes mellitus, measure the salivary levels of two adipokines "leptin and resistin", pH and flow rate and then correlate between these clinical periodontal, biochemical and physical parameters in eac
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