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.
The utilization of sugarcane molasses (SCM), a byproduct of sugar refining, offers a promising bio-based alternative to conventional chemical admixtures in cementitious systems. This study investigates the effects of SCM at five dosage levels, 0.25%, 0.50%, 0.75%, 1.00%, and 1.25% by weight of cement, on cement mortar performance across fresh, mechanical, thermal, durability, and density criteria. A comprehensive experimental methodology was employed, including flow table testing, compressive strength (7, 14, and 28 days) and flexural strength measurements, embedded thermal sensors for real-time hydration monitoring, water absorption and chloride ion penetration tests, as well as 28-day density determination. Results revealed clear
... Show MoreBackground: Nursing interventions tailored to the smoking triggers in patients with non-communicable chronic diseases are essential. However, these interventions are scant due to the nature of factors associated with smoking cessation and the poor understanding of the effect of nurse-led intervention in Iraq.Purpose: This study aimed to determine the dominant smoking triggers and examine the effects of a tailored nursing intervention on smoking behavior in patients with non-communicable chronic diseases.Methods: Convenience samples of 128 patients with non-communicable chronic diseases, male and female patients, who were 18-70 years old, were recruited in this quasi-experimental, randomized comparative trial in the outpatient clinic
... Show MoreThe application of the test case prioritization method is a key part of system testing intended to think it through and sort out the issues early in the development stage. Traditional prioritization techniques frequently fail to take into account the complexities of big-scale test suites, growing systems and time constraints, therefore cannot fully fix this problem. The proposed study here will deal with a meta-heuristic hybrid method that focuses on addressing the challenges of the modern time. The strategy utilizes genetic algorithms alongside a black hole as a means to create a smooth tradeoff between exploring numerous possibilities and exploiting the best one. The proposed hybrid algorithm of genetic black hole (HGBH) uses the
... Show MoreIn this investigation, water-soluble N-Acetyl Cysteine Capped-Cadmium Telluride QDs (NAC/CdTe nanocrystals), utilizing N-acetyl cysteine as a stabilizer, were prepared to assess their potential in differentiating between DNA extracted from pathogenic bacteria (e.g. Escherichia coli isolated from urine specimen) and intact DNA (extracted from blood of healthy individuals) for biomedical sensing prospective. Following the optical characterization of the synthesized QDs, the XRD analysis illustrated the construction of NAC-CdTe-QDs with a grain size of 7.1 nm. The prepared NAC-CdTe-QDs exhibited higher PL emission features at of 550 nm and UV-Vis absorption peak at 300 nm. Additionally, the energy gap quantified via PL and UV–Vis were 2.2 eV
... Show MoreÖZET
Bir millet veya topluluk kendi varlığını ancak kültürel değerleri ile koruyabilecek; gelecek nesillere aktarabilecek ve dünyanın diğer milletlerine tanıtabilecektir. Böylece dünya milletleri arasında ortak kültürel ve toplumsal değerler tespit edilecek ve bu ortak değerlerden hareketle insanlık hizmetine sunulabilecek çok güzel çalışmalar hazırlanabilecektir. Taşıdıkları zengin kültürel ve toplumsal değerlerinden dolayı masalların halk edebiyatı ürünlerinin şah damarı niteliğinde oldukları söylenebilir. Bu çalışmada Türk okuruna Bağdat halk masallarını tanıtmak için sahadan derlenen on masal metnine yer verilmiştir. Bağdat masal metinlerinin tip ve motif
... Show MoreThis article aims to provide a bibliometric analysis of intellectual capital research published in the Scopus database from 1956 to 2020 to trace the development of scientific activities that can pave the way for future studies by shedding light on the gaps in the field. The analysis focuses on 638 intellectual capital-related papers published in the Scopus database over 60 years, drawing upon a bibliometric analysis using VOSviewer. This paper highlights the mainstream of the current research in the intellectual capital field, based on the Scopus database, by presenting a detailed bibliometric analysis of the trend and development of intellectual capital research in the past six decades, including journals, authors, countries, inst
... Show MoreAbstract The research investigates in detail the fascinating story of its title character, which may work as an allegory for Africa itself in its past. Ama Ata Aidoo is miscellaneous writers who wrote in different literary genre like drama , short stories novel and , poetry and criticism . She is also an active feminist. Aidoo is against the colonial practice and its influence on African minds. Aidoo's play Anowa confronts painful issues in Africa's past, mostly those of the slave trade. She goes further to tackle issues of patriarchal domination and African feminism, like the relationships between individuals and society, women and motherhood, men and women, husbands and wives, mothers and daughters, and above all the future invasion
... Show MoreWater flow into unsaturated porous media is governed by the Richards’ partial differential equation expressing the mass conservation and Darcy’s laws. The Richards’ equation may be written in three forms,where the dependent variable is pressure head or moisture content, and the constitutive relationships between water content and pressure head allow for conversion of one form into the other. In the present paper, the “moisture-based" form of Richards’ equation is linearized by applying Kirchhoff’s transformation, which
combines the soil water diffusivity and soil water content. Then the similarity method is used to obtain the analytical solution of wetting front position. This exact solution is obtained by means of Lie’s
Our goal in the present paper is to recall the concept of general fuzzy normed space and its basic properties in order to define the adjoint operator of a general fuzzy bounded operator from a general fuzzy normed space V into another general fuzzy normed space U. After that basic properties of the adjoint operator were proved then the definition of fuzzy reflexive general fuzzy normed space was introduced in order to prove that every finite dimensional general fuzzy normed space is fuzzy reflexive.