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.
One of the main causes for concern is the widespread presence of pharmaceuticals in the environment, which may be harmful to living things. They are often referred to as emerging chemical pollutants in water bodies because they are either still unregulated or undergoing regulation. Pharmaceutical pollution of the environment may have detrimental effects on ecosystem viability, human health, and water quality. In this study, the amount of remaining pharmaceutical compounds in environmental waters was determined using a straightforward review. Pharmaceutical production and consumption have increased due to medical advancements, leading to concerns about their environmental impact and potential harm to living things due to their increa
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Multilayer reservoirs are currently modeled as a single zone system by averaging the reservoir parameters associated with each reservoir zone. However, this type of modeling is rarely accurate because a single zone system does not account for the fact that each zone's pressure decreases independently. Pressure drop for each zone has an effect on the total output and would result in inter-flow and the premature depletion of one of the zones. Understanding reservoir performance requires a precise estimation of each layer's permeability and skin factor. The Multilayer Transient Analysis is a well-testing technique designed to determine formation properties in more than one layer, and its effectiveness over the past two decades has been
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Mobile ad hoc network security is a new area for research that it has been faced many difficulties to implement. These difficulties are due to the absence of central authentication server, the dynamically movement of the nodes (mobility), limited capacity of the wireless medium and the various types of vulnerability attacks. All these factor combine to make mobile ad hoc a great challenge to the researcher. Mobile ad hoc has been used in different applications networks range from military operations and emergency disaster relief to community networking and interaction among meeting attendees or students during a lecture. In these and other ad hoc networking applications, security in the routing protocol is necessary to protect against malic
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Alizarin is one of the popularly used and wide separated compounds with a chemical name (1,2- dihydroxy-9,10-anthraquinone) which belong to the anthraquinones family that contain three aromatic conjugated rings and in the central rings it contains two ketonic groups.1
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Environmental pollution is regarded as a major problem, and traditional strategies such as chemical or physical remediation are not sufficient to overcome the problems of pollution. Petroleum-contaminated soil results in ecological problems, representing a danger to human health. Bioremediation has received remarkable attention, and it is a procedure that uses a biological agent to remove toxic waste from contaminated soil. This approach is easy to handle, inexpensive, and environmentally friendly; its results are highly satisfactory. Bioremediation is a biodegradation process in which the organic contaminants are completely mineralized to inorganic compounds, carbon dioxide, and water. This review discusses the bioremediation of petroleum-
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