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 research aims to clarify the COBIT5 framework for IT governance and to develop of a criterion based on Balanced Scorecard that contributes in measuring the performance of IT governance. To achieve these goals, the researchers adopted the deductive approach in the design of balanced scorecard to measure the IT governance at the Bank of Baghdad that was chosen because it relied heavily on IT.
The research has reached a number of conclusions, the most important of which is that the performance of IT department in the Bank of Baghdad falls within the good level that requires constant monitoring, the most committed items of Balanced Scorecard by the Bank were customer, internal operation, growth and finally the financial item; IT
... Show MoreThe current research aims at finding out how to properly and correctly manage waste and solid waste and reduce the difficulties faced by all countries. However, it is becoming increasingly acute in developed cities because their economies are growing rapidly. It is necessary to identify the modern methods used in developed countries in managing wastes. The use of modern waste management techniques is a coordinated effort by international agencies within the borders responsible for them. The problem of the study can be identified in the lack of clarity of environmental management procedures in place. The importance of the research contributes to providing greater capacity to the administrative and technical leadership in the municipality
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The current research problem includes a variety of research motivations to serve the private health sector, which is witnessing a great competition from internal and external environments. In this regard, private medical clinics are increasingly seeking to attract and retain customers through the quality of their service offerings represented by health services. Innovative and effective marketing methods to improve performance and stay in competition, by relying on the physical evidence of the product as a component of the marketing mix of services and its role in particular in packaging and supporting the health service with concrete evidence that affects the customer an
... Show MoreRecently a large number of extensive studies have amassed that describe the removal of dyes from water and wastewater using natural adsorbents and modified materials. Methyl orange dye is found in wastewater streams from various industries that include textiles, plastics, printing and paper among other sources. This article reviews methyl orange adsorption onto natural and modified materials. Despite many techniques available, adsorption stands out for efficient water and wastewater treatment for its ease of operation, flexibility and large-scale removal of colorants. It also has a significant potential for regeneration recovery and recycling of adsorbents in comparison to other water treatment methods. The adsorbents described herein were
... Show MoreSickle cell disease (SCD) is a hereditary ailment that can cause severe pain and suffering to people who are affected. However, with continued investment in research and treatment options, we can make progress towards improving the lives of those with SCD. Over 40% of patients experience painful vaso-occlusive crises (VOCs), so we must work towards finding solutions and providing support for those living with this condition, These episodes, a hallmark of SCD, significantly contribute to morbidity, mortality, and a diminished quality of life, while also incurring substantial healthcare costs. Chronic pain particularly affects older adolescents and adults with SCD, with over half reporting daily discomfort. Opioid-based analgesics, though sti
... Show MoreThis article is an endeavour to highlight the relationship between social media and language evolution. It reviews the current theoretical efforts on communication and language change. The descriptive design, which is theoretically based on technological determision, is used. The assumption behind this review is that the social media plays a significant role in language evolution. Moreover, different platforms of social media are characterized by being the easiest and fastest means of communication. It concludes that the current theoretical efforts have paid much attention to the relationship between social media and language evolution. Such efforts have highlighted the fact that social media platforms are awash with a lot of acronyms, cybe
... Show MoreReservoir characterization is an important component of hydrocarbon exploration and production, which requires the integration of different disciplines for accurate subsurface modeling. This comprehensive research paper delves into the complex interplay of rock materials, rock formation techniques, and geological modeling techniques for improving reservoir quality. The research plays an important role dominated by petrophysical factors such as porosity, shale volume, water content, and permeability—as important indicators of reservoir properties, fluid behavior, and hydrocarbon potential. It examines various rock cataloging techniques, focusing on rock aggregation techniques and self-organizing maps (SOMs) to identify specific and
... Show MoreStereo lithography (SLA) three-dimensional (3D) printing process is a type of additive manufacturing techniques that uses digital models from computer-aided design to automatically produce customized 3D objects. Around 30 years, it has been widely utilized in the manufacturing, design, engineering, industrial sectors and its applications in dentistry for manufacturing prosthodontics are very important. The stereo lithography technology is highly regarded because it can produce items with excellent precision especially when selecting the best process parameters. This review article offers a useful and scientific summary of SLA three-dimensional printing technology and its brief history. The specific type of 3D printers which is SLA t
... Show MoreModerately, advanced national election technologies have improved political systems. As electronic voting (e-voting) systems advance, security threats like impersonation, ballot tampering, and result manipulation increase. These challenges are addressed through a review covering biometric authentication, watermarking, and blockchain technologies, each of which plays a crucial role in improving the security of e-voting systems. More precisely, the biometric authentication is being examined due to its ability in identify the voters and reducing the risks of impersonation. The study also explores the blockchain technology to decentralize the elections, enhance the transparency and ensure the prevention of any unauthorized alteration or
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