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 study, the energy charging mechanism is mathematically modeled to determine the impact of design modifications on the thermofluidic behavior of a phase change material (PCM) filled in a triplex tube containment geometry. The surface area of the middle tube, where the PCM is placed, is supported by single or multi-internal frustum tubes in vertical triplex tubes to increase the performance of the heating and cooling of the system. In addition to the ordinary straight triplex tubes, three more scenarios are considered: (1) changing the middle tube to the frustum tube, (2) changing the inner tube to the frustum tube, and (3) changing both the internal and central tubes to the frustum tubes. The impact of adopting the tube desig
... Show MoreBackground: The size of the nasopharyngeal airway was believed to have an important role in the development of the dentofacial structure. This study was carried out to test the relation between the nasopharyngeal dimensions with some dento-cranial measurements in class I and II jaw relationship. Materials and Methods: This study was done on 60 subjects (30 males and 30 females) at age range 18-25 years. Cephalometric radiograph has been taken to each subject and the measurements were recorded. The sample was divided into two groups, class I skeletal relationship (15 males and 15 females) and class II skeletal relationship (15 males and 15 females). Comparisons between the different study groups were undertaken. Results: In class I skeletal
... Show MoreA new technique in cultivation by installing membrane sheet below the crop’s root zone was helped to save irrigation water in the root zone, less farm losses, increasing the field water use efficiency and water productivity. In this paper, the membrane sheet was installed below the root zone of zucchini during the summer growing season 2017 in open field. This research was carried out in a private field in Babil governorate at Sadat Al Hindiya Township reached 72 km from Baghdad. Surface trickle irrigation system was used for irrigation process. Two treatment plots were used, treatment plot T1 using membrane sheet and treatment plot T2 without using the membrane sheet. The applied irrigation water, time of
... Show MoreThe study seeks to determine the levels of credit structure (independent variable) depending on its components (loans, credit disseminate, other facilities) To get the eight patterns of the structure of bank credit for the purpose of assessing the relationship between changes in levels of each style of structure credit (increase or decrease) and reflected in maximizing the value of the Bank(The adopted a measured variable depending on the approximate equation of simple Tobin's Q) to determine the style that achieves the highest value of the Bank, to take advantage of it in management, planning and control by knowing the strengths and weaknesses of the historical distribution of the facilities . the sample of the
... Show MoreVarious literary studies have investigated the psychological, social and cultural effects of traumatic events. They give voice to traumatised victims and enable them to convey and confront their traumas. However, these studies present a one-sided view, concentrating largely on the presentation of trauma in the industrial societies of the Western world. Recently, increasing attention has been devoted to identifying and depicting the forms and types of trauma that have been experienced in marginalised and neglected societies, such as the Iraqi society. Iraq has witnessed the unexpected fall of a brutal dictatorship, Western invasion and an unprecedented rise of sectarian discourses. This extreme violence has deeply affected many aspec
... Show MoreIncreasing demands on producing environmentally friendly products are becoming a driving force for designing highly active catalysts. Thus, surfaces that efficiently catalyse the nitrogen reduction reactions are greatly sought in moderating air-pollutant emissions. This contribution aims to computationally investigate the hydrodenitrogenation (HDN) networks of pyridine over the γ-Mo2N(111) surface using a density functional theory (DFT) approach. Various adsorption configurations have been considered for the molecularly adsorbed pyridine. Findings indicate that pyridine can be adsorbed via side-on and end-on modes in six geometries in which one adsorption site is revealed to have the lowest adsorption energy (
... Show MoreHusbands’ violence towards their wives is one of the greatly important issues in social sciences. Accordingly, the current study aims at determining the levels of violence practiced by husbands towards their wives to propose a professional program from the perspective of the general practice of social work to overcome such a phenomenon. The study is descriptive in nature, where the researcher has used a comprehensive social survey method. To achieve the goal of the study, the researcher has prepared a questionnaire that consisted of two parts. The first part contains the primary data of the two sections, and the second contains (38) phrases distributed over four axes to measure the levels and types of violence among the sample’s memb
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