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 Incentives legislation aims to raise the efficiency of job performance of all kinds through optimal investment of human resources and their capabilities to raise or increase and production influence and provide distinguished and creative services such as The Incentives Law of Productive Ministries Employees No. 20 of 1993 and instructions issued by ministries and relevant Facilities regarding incentives for their affiliates based on provisions Public Companies Law and the instructions of the Higher Education Fund issued by the Ministry of Higher Education and Scientific Research. The human element is the most unstable and complex element of production as it is characterized by a set of feelings and emotions that is expresses
... Show MoreFocusing on the negative role of default risk on banks, as it is one of the most important risks facing banks, which are difficult to determine accurately, and its reflection on the indicators of profitability of cash flows. The increasing competition between banks led to an increase in the credit facilities granted by banks, and was accompanied by an increase in exposure to the risks of default, which led to an impact on the level of performance of banks in terms of achieving the required return according to the levels of high competition. Therefore, the problem of this study focused on the extent to which the risk indicators of default affect the profitability indicators of the cash flows of the banks research sample in the profit
... Show MoreIn this research local wheat peel was used as an adsorbent surface for removal of Azure B (AB) dye from the aqueous solution. The adsorption process was performed at different experimental parameters, equilibrium time, temperature, ionic strength and solution pH. The isotherms of adsorption are of H-type as compared with Giles curves and the adsorption data were coincide with Freundlich equation. The adsorption kinetic data were analyzed using pseudo- first and second order kinetic models. The effect of temperature was studied and the amount of dye adsorbed was found to increase with the increasing of temperature from 25 to 50 oC. The values of thermodynamic functions like enthalpy and entropy have been estimated. The quantity of adso
... Show MoreA new method for construction ion-selective electrode (ISE) by heating reaction of methyl orange with ammonium reineckate using PVC as plasticizer for determination methyl orange and determination Amitriptyline Hydrochloried drug by formation ion-pair on electrode surface . The characteristics of the electrode and it response as following : internal solution 10-4M , pH (2.5-5) ,temperature (20-30) and response time 2 sec. Calibration response for methyl orange over the concentrationrange 10-3 -10-9 M with R=0.9989 , RSD%=0.1052, D.O.L=0.315X10-9 MEre%=(-0.877- -2.76) , Rec%.=(97.230 -101.711) .
This investigation aims to explore the potential of waterworks sludge (WS), low-cost byproduct of water treatment processes, as a sorbent for removing Congo Red (CR) dyes. This will be achieved by precipitating nano-sized (MgAl-LDH)-layered double hydroxide onto the surface of the sludge. The efficiency of utilizing MgAl-LDH to modify waterworks sludge (MWS) for use in permeable reactive barrier technology was confirmed through analysis with Fourier transform infrared and X-ray diffraction. The isotherm model was employed to elucidate the adsorption mechanisms involved in the process. Furthermore, the COMSOL model was utilized to establish a continuous testing model for the analysis of contaminant transport under diverse conditions. A st
... Show MoreA simple, environmental friendly and selective sample preparation technique employing porous membrane protected micro-solid phase extraction (μ-SPE) loaded with molecularly imprinted polymer (MIP) for the determination of ochratoxin A (OTA) is described. After the extraction, the analyte was desorbed using ultrasonication and was analyzed using high performance liquid chromatography. Under the optimized conditions, the detection limits of OTA for coffee, grape juice and urine were 0.06 ng g−1, 0.02 and 0.02 ng mL−1, respectively while the quantification limits were 0.19 ng g−1, 0.06 and 0.08 ng mL−1, respectively. The recoveries of OTA from coffee spiked at 1, 25 and 50 ng g−1, grape juice and urine samples at 1, 25 and 50 ng mL
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