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.
Introduction: Cerebral hydatid disease (CHD) is rare and the multiple-cystic variety is even rarer. In this paper, we report a case of multiple CHD and explore a possible link with a preceding spontaneous intracerebral haemorrhage (ICH). Case presentation: A 27-year old gentleman with a history of surgically-evacuated, spontaneous ICH presented with severe headache, left-sided weakness - Medical Research Council (MRC) grade II - and recurrent tonic-clonic seizures, while on a full dose of anti-epileptic medication. Brain magnetic resonance imaging (MRI) scans showed multiple intra-axial cystic lesions in the right hemisphere. The cysts were removed intact using Dowling’s technique through a large temporoparietal crani
... Show MoreThe finite element method has been used in this paper to investigate the behavior of precast reinforced concrete dapped-ends beams (DEBs) numerically. A parametric investigation was performed on an experimental specimen tested by a previous researcher to show the effect of numerous parameters on the strength and behavior of RC dapped-end beams. Reinforcement details and steel arrangement, the influence of concrete compressive strength, the effect of inclined load, and the effect of support settlement on the strength of dapped-ends beams are examples of such parameters. The results revealed that the dapped-end reinforcement arrangement greatly affects the behavior of dapped end beam. The failure load decreases by 25% when
... Show MoreBackground: As the development of zirconia crown using CAD/CAM technology, the usage of full zirconia crown is gradually increased. The aim of this in-vitro study was to evaluate and contrast the vertical marginal fit of single all-ceramic translucent zirconia crowns constructed from different brands translucent zirconia blanks. Materials and Methods: An acrylic resin model of a left maxillary premolar was prepared all around the tooth with (1 mm) depth and 3D scanning to get fifteen STL files, then distributed into three groups (Imes-icor, Whitepeaks and Dental direct), 3D scanning and milling machine by Imes-icor CAD/CAM devise. Marginal gaps along vertical planes were measured at four indentations at the (mid mesial, mid distal, mid bucc
... Show MoreFerrite with general formula Ni1-x Cox Fe2O4(where x=0.0.1,0.3,0.5,0.7, and 0.9), were prepared by standard ceramic technique. The main cubic spinel structure phase for all samples was confirmed by x-ray diffraction patterns. The lattice parameter results were (8.256-8.299 °A). Generally, x -ray density increased with the addition of Cobalt and showed value between (5.452-5.538gm/cm3). Atomic Force Microscopy (AFM) showed that the average grain size and surface roughness was decreasing with the increasing cobalt concentration. Scanning Electron Microscopy images show that grains had an irregular distribution and irregular shape. The A.C conductivity was found to increase with the frequency and the addition of Cobal
... Show MoreUrban agriculture is one of the important urban uses of land in cities since the inception of cities and civilizations, but the great expansion of cities in the world during the twentieth century and the beginning of the twentieth century and the increase in the number of urban residents compared to the rural population has led to a decline in this use in favor of other uses.
This decline in agricultural and green land areas in cities has negatively affected the environment, natural life and biological diversity in cities in addition to the great impact on the climate and the increase in temperatures and the negative impact on the economic side, since urban agriculture is an important pillar of the economy, especially
... Show MoreThe research summarizes the knowledge of the dimensions and denotations of T.V advertisement; and its constituents for building it through the semiotic approach of an ad sample represented by the announcement of Zain Kuwait Telecom Company which carries the title "Mr. President" using Roland Barth's approach, starting with the designation, implicit, and linguistic reading to reach the narrative features and their denotations. That makes television advertising as a semiotic and pragmatic discourse in view of the still and motion picture with its efficiency and strength to inform and communicate. And what lies in it of aesthetic, artistic elements; informational and effective power in influencing the recipients by focusing on narratives and a
... Show MoreThe ongoing COVID‐19 pandemic caused by SARS‐CoV‐2 is associated with high morbidity and mortality. This zoonotic virus has emerged in Wuhan of China in December 2019 from bats and pangolins probably and continuing the human‐to‐human transmission globally since last two years. As there is no efficient approved treatment, a number of vaccines were developed at an unprecedented speed to counter the pandemic. Moreover, vaccine hesitancy is observed that may be another possible reason for this never ending pandemic. In the meantime, several variants and mutations were identified and causing multiple waves globally. Now the safety and efficacy of these vaccines are debatable and recommended to d
Background: Obesity represents a clear and
present danger to the health of children and
adolescents. Its prevalence among American
youth has doubled in the past 3 decades, and
there are now more overweight and obese
adults in the United States than adults of
normal weight.
Objectives of the study:
1- Finding whether screen watching among
adolescents has an effect on increasing
prevalence overweight and obesity.
2- The effect of other variables like physical
activity, eating in front of screen, eating under
stress on obesity and overweight among the
subjects sample.
Patients &Methods: During 3 months period a
cross sectional survey was conducted on 4
high schools at Baghdad with total
A numerical investigation has been performed to study the effect of eccentricity on unsteady state, laminar aiding mixed convection in a horizontal concentric and eccentric cylindrical annulus. The outer cylinder was kept at a constant temperature
while the inner cylinder was heated with constant heat flux. The study involved numerical solution of transient momentum (Navier-Stokes) and energy equation using finite difference method (FDM), where the body fitted coordinate system (BFC) was
used to generate the grid mesh for computational plane. The governing equations were transformed to the vorticity-stream function formula as for momentum equations and to the temperature and stream function for energy equation.
A computer progra