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 surgery Keywords: Non-surgical treatment of anal fissure, fissure in ano, sphicterotomy,botulinum toxin in anal fissures, glyceryl trinitrate. Chemical sphincteratomy, pharmacological sphincteratomy.
It has increasingly been recognised that the future developments in geospatial data handling will centre on geospatial data on the web: Volunteered Geographic Information (VGI). The evaluation of VGI data quality, including positional and shape similarity, has become a recurrent subject in the scientific literature in the last ten years. The OpenStreetMap (OSM) project is the most popular one of the leading platforms of VGI datasets. It is an online geospatial database to produce and supply free editable geospatial datasets for a worldwide. The goal of this paper is to present a comprehensive overview of the quality assurance of OSM data. In addition, the credibility of open source geospatial data is discussed, highlight
... Show MoreThyroid hemiagenesis (THA) is a rare congenital anomaly in which one lobe of thyroid gland fails to develop during embryological stage. Agenesis may be unilateral, total or isthmic. Left thyroid lobe is more commonly involved than right lobe in hemiagenesis. Agenesis of the isthmus was seen in 50% of cases. Left sided hemiagenesis is more common than right sided hemiagenesis with a Left to right ratio of 4:1. Clinically patients can be euthyroid, hypothyroid or hyperthyroid. Often it is diagnosed as an incidental finding during ultrasonography (USG) study of neck, which can easily diagnose this condition.
Actual incidence of THA is unknown; most cases are diagnosed in patients admitted for thyroid scan or thyroid surgery because
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It has increasingly been recognised that the future developments in geospatial data handling will centre on geospatial data on the web: Volunteered Geographic Information (VGI). The evaluation of VGI data quality, including positional and shape similarity, has become a recurrent subject in the scientific literature in the last ten years. The OpenStreetMap (OSM) project is the most popular one of the leading platforms of VGI datasets. It is an online geospatial database to produce and supply free editable geospatial datasets for a worldwide. The goal of this paper is to present a comprehensive overview of the quality assurance of OSM data. In addition, the credibility of open source geospatial data is discussed, highlighting the diff
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The application of pultruded (GFRP) composite has become increasingly prominent in civil infrastructure projects. This study provides a comprehensive analysis of experimental and numerical studies conducted on the mechanical characteristics of (GFRP) composites across various temperature conditions, encompassing ambient and fire scenarios. The compilation comprises over 100 scholarly articles that examine the mechanical behavior of (GFRP) materials, specifically emphasizing their tensile and compressive strengths, showed the mechanical properties of (GFRP) materials are commonly compromised when exposed to high temperatures that approach or surpass the resin's glass transition temperature (Tg). In contrast, temperatures that are low
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Hygienic engineering has dedicated a lot of time and energy to studying water filtration because of how important it is to human health. Thorough familiarity with the filtration process is essential for the design engineer to keep up with and profit from advances in filtering technology and equipment as the properties of raw water continue to change. Because it removes sediment, chemicals, odors, and microbes, filtration is an integral part of the water purification process. The most popular technique for treating surface water for municipal water supply is considered fast sand filtration, which can be achieved using either gravity or pressure sand filters. Predicting the performance of units in water treatment plants is
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Hygienic engineering has dedicated a lot of time and energy to studying water filtration because of how important it is to human health. Thorough familiarity with the filtration process is essential for the design engineer to keep up with and profit from advances in filtering technology and equipment as the properties of raw water continue to change. Because it removes sediment, chemicals, odors, and microbes, filtration is an integral part of the water purification process. The most popular technique for treating surface water for municipal water supply is considered fast sand filtration, which can be achieved using either gravity or pressure sand filters. Predicting the performance of units in water treatment plants is a basic pri
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Melanoides tuberculata (O. F. Müller, 1774), a freshwater snail native to eastern Mediterranean, eastern Africa, southeast Asia, southern Asia, India, and Malaysia, it is an effective invader and is now nearly globally distributed. This snail has been studied with interest because of its rapidly distributed, and because of being can serve as compatible intermediate host for many of trematodes in the world. We have summarized information from many articles in order to highlight the most important aspects of this invader snail life.
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Liquefied petroleum gases (LPG) consist of hydrocarbons obtained by refining crude oil, either from propane or butane or a mixture of the two. There are often other components such as propylene, butylene or other hydrocarbons, but they are not the main component. The study aims to review previous studies dealing with designing an LPG system to deliver gas to residential campuses and buildings. LPG is extracted from natural gas NG by several processes, passing through fractionation towers and then pressuring into CNG storage tanks. Gas contains several problems, including gas leakage through the pipes and leads to fires or explosions in LPG storage and distribution tanks, so safety conditions were taken in the design and implementation. T
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