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 city is a built-up urban space and multifunctional structures that ensure safety, health and the best shelter for humans. All its built structures had various urban roofs influenced by different climate circumstances. That creates peculiarities and changes within the urban local climate and an increase in the impact of urban heat islands (UHI) with wastage of energy. The research question is less information dealing with the renovation of existing urban roofs using color as a strategy to mitigate the impact of UHI. In order to achieve local urban sustainability; the research focused on solutions using different materials and treatments to reduce urban surface heating emissions. The results showed that the new and old technologies, produ
... Show MoreOur research tends to study the poetic attempt of Badr Shakir Al-Sayyab and examine it stylistically, and we suggested his mature collection '' Rain song'' as a pattern for our textual analysis of the poet's attempt.
In the beginning , we confirm that branches of applied structures meet to produce poetry such as narration , drama , cinema , mythology , allegory , various religious and historical texts , previous events , and special cumentary events related to work production. If all above-mentioned was complicated and disregarded throughout a single text , the text writer would not secure positive results that might keep open continuity between him and his readers.
Therefore , this issue w
... Show MoreWohlfahrtia longicorpuris sp. nov., from Iraq described, illustrated and distinguished from related species. The adults were reared from larvae collected from ulcer of a human face. Wohlfahrtia Brauer and Bergenstam is one of most important genus,which contains 19 species (Pape, 1998), some of these produce myiasis in mammals (Verves,1985).Taxonomic revision of this genus has been carried out by the following authors: Rohdendrof (1956), Zumpt (1965) and Pape (1996).
Abstract This study seeks to deal academically with how the EU treats clandestine immigration, through adopting a purley security approach, based on the European understanding of security threats posed to the security of communities and States in EU at all levels. So they agreed upon criminalizing this threat within the bloc while using repressive tools and steps to limit illegal immigrants flow to European territories. Accordingly, the EU gave the phenomen a security character. So it takes it from low politics level , that of employment and economic field to that of high politics, as a new security problem lying within a new security language embraced by ruling European elites, in other words EU touched on this issue as a speech act emp
... Show MoreThe aim: to evaluate combined microscopy techniques for determining the morphological and optical properties of methadone hydrochloride (MDN) crystals. Materials and methods: MDN crystal formation was optimized using a closed container method and crystals were characterized using polarized light microscope (PLM), scanning electron microscopy (SEM) and confocal microscopy (CM). SEM and CM were used to determine MDN crystal thickness and study its relationship with crystal retardation colours using the Michel-Levy Birefringence approach. Results: Dimensions (mean±SD) of diamond shaped MDN crystals were confirmed using SEM and CM. Crystals were 46.4±15.2 Vs 32.0±8.3 µm long, 28.03±8.2 Vs 20.85±5.5 µm wide, and 6.62±
... Show MoreReceipt date:06/23/2020 accepted date:7/15/2020 Publication date:12/31/2021
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The executive authority differs from one country to another, as it differs from a federal state to another according to the nature of the applied political systems, so this research focused on federal states according to their political systems, then going into the details of the executive authority and its role In the federal states by referring to the four federal experiments
... Show MoreThe study explored applications of artificial intelligence and its dialectical relationship with international human rights law of individuals, which requires assessing the effects of this technology on human rights and freedoms. The problem of privacy of humanity, as AI technologies can control human rights and freedoms, while monitoring potential violations in this context. The study use of documentary research and qualitative lens to analyze the data. In conclusion, unawareness of the use of AI may impose significant hurdles on future generations and may infringe on human rights across all sectors of society. The government should mandate obligations for artificial intelligence businesses concerning education, health, human right
... Show MoreMalaysia's growing population and industrialisation have increased solid waste accumulation in landfills, leading to a rise in leachate production. Leachate, a highly contaminated liquid from landfills, poses environmental risks and affects water quality. Conventional leachate treatments are costly and time-consuming due to the need for additional chemicals. Therefore, the Electrocoagulation process could be used as an alternative method. Electrocoagulation is an electrochemical method of treating water by eliminating impurities by applying an electric current. In the present study, the optimisation of contaminant removal was investigated using Response Surface Methodology. Three parameters were considered for optimisation: the curr
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