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.
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One of the bigger problems in drinking water is disinfection by-products (DBPs) that come from chlorinated disinfection. This study’s goal was to evaluate the drinking water in Al-Yarmouk Teaching Hospital, Ibn Sina Hospital and Ibn-Al-Nafis Hospital. Samples were collected between October 2018 and September 2019. Physical and chemical characteristics of the water were studied, including (temperature, hydrogen ion (pH), total dissolved solids (TDS), electrical conductivity (EC), turbidity, free residual chlorine, total organic carbon (TOC), total trihalomethanes (THMs), total halo acetic acid (THAAs)). Data analysis showed the highest value of study temperature, pH, TDS, EC, turbidity, free residual chlorine and TOC which was
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In the years recently city planning projects have been confirmed sustainable high concentration on planning streets and pedestrian paths being the most prominent component of the urban structure in the city and these me and diverse departments link the city’s sectors and serve as a space for economic, service, and social activities. On the other hand, pedestrian traffic is an essential component of the various means of transportation within the city. Suffer cities in the Middle East and Arab cities in particular are neglecting pedestrian paths in the vital urban environment. Vehicle control mechanisms on roads, and changing the uses of pedestrian paths as result of encroaching on the sidewalks designated for pedestrians. Which leads to a
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Amorphization of drug has been considered as an attractive approach in improving drug solubility and bioavailability. Unlike their crystalline counterparts, amorphous materials lack the long-range order of molecular packing and present the highest energy state of a solid material. Co-amorphous systems (CAM) are an innovative formulation technique by where the amorphous drugs are stabilized via powerful intermolecular interactions by means of a low molecular co-former.
This review highlights the different approaches in the preparation of co-amorphous drug delivery system, the proper selection of the co-formers. In addition, the recent advances in characterization, Industrial scale and formulation will be discussed.
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Photonic crystal fiber interferometers are widely used for sensing applications. In this work, solid core-Photonic crystal fiber based on Mach-Zehnder modal interferometer for sensing refractive index was presented. The general structure of sensor applied by splicing short lengths of PCF in both sides with conventional single mode fiber (SMF-28). To apply modal interferometer theory; collapsing technique based on fusion splicing used to excite higher order modes (LP01 and LP11). Laser diode (1550 nm) has been used as a pump light source. Where a high sensitive optical spectrum analyzer (OSA) was used to monitor and record the transmitted. The experimental work shows that the interference spectrum of Photonic crystal fiber interferometer
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Expansive soils are recognized by their swelling potential upon wetting due to the existence of some clay minerals such as montmorillonite. An effective solution was found to avoid the danger of such soils by using piles. A single pile embedded in an elasto-plastic expansive soil has been analyzed by using one of the available software which is ABAQUS to investigate the effect of applied loads on pile’s top and investigate the effect of swelling soils on load carrying capacity of the pile. The result shows that as the pile is axially loaded at its top, the axial force along the pile gradually changes from (tension) to (compression) and the pile tends to move downward. The applied load needed to initiate pile’s settlement depend
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