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.
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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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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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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تعد مراجعة النظير واحدة من الأســاليب الحديثة فــي مجال الرقابة والتدقيق ونشــأة كأداة لقياس مــدى فاعليــة الرقابــة علــى الجــودة هو لبنة أساسية في إدارة الجودة الشاملة ووسيلة لتحســين أدوات الرقابــة المعمول بها، وللتحقق من مدى الانسجام بين المعايير الدولية للأجهزة العليا للرقابة المالية والمحاسبة والاجراءات المعمول بها من قبل الاجهزة العليا للرقابة وعليه فأن مراجعة النظير أداة تستخدم ف
... Show MoreThis narrative review focused on research investigating the impact of loneliness on the prevalence of dementia and its relationship with other risk factors. A comprehensive and rigorous search was conducted using a variety of scientific databases with specific keywords to identify all prior studies that examined the correlation between dementia and loneliness. The inquiry was confined to articles published in English from January 2017 to March 2024. The narrative review identified a consensus regarding the role of loneliness in enhancing the risk of all‐cause dementia, with a particular emphasis on the subjective perception of loneliness. This phenomenon may be caused by the sensations of exclusion, discrimination, and alienation that are
... Show MoreThis study looks into the many methods that are used in the risk assessment procedure that is used in the construction industry nowadays. As a result of the slow adoption of novel assessment methods, professionals frequently resort to strategies that have previously been validated as being successful. When it comes to risk assessment, having a precise analytical tool that uses the cost of risk as a measurement and draws on the knowledge of professionals could potentially assist bridge the gap between theory and practice. This step will examine relevant literature, sort articles according to their published year, and identify domains and qualities. Consequently, the most significant findings have been presented in a manne
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Antibiotics are essential for treating infectious diseases, but their overuse and adverse effects are raising concerns about global public health. The pervasiveness of antibiotic contamination in aquatic environments has drawn increased attention in recent years. The primary concern regarding the release of antibiotics into the environment is the potential for microorganisms to become resistant to antibiotics. This review article summarizes the analytical methods used to determine the presence of trimethoprim and metronidazole in various environmental samples. These antibiotics have traditionally been analyzed using tandem mass spectrometry or high-performance liquid chromatography coupled to mass spectrometry; fluorescence or ultrav
... Show MoreBackground: Thyroid surgery is most common endocrine surgery in general surgical practice. Objectives: the aim of this work is to evaluate the feasibility, benefits and outcomes of open mini-incision thyroidectomy and compared the results with that of conventional thyroidectomy. The comparison between the two groups was in term of incision length, amount of blood loss, time of operation, postoperative pain, hospital stay and the cosmetic outcomes.Type of the study: this is a single-blinded randomized controlled studyMethods: This study compared the advantages and outcomes of 22 patients subjected to mini-incision thyroidectomy (Group A) with the equal numbers of patients subjected to conventional thyroidectomy (Group B).Results: the oper
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