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.
This research paper is about synoptic climate specifically with in the upper air layers
using upper air layers maps analysis which are maps of thickness for the level 1000 – 500
MB, that their high average ranges between 100 – 5600 M above surface. This research paper
focuses on studying special and temporal variations of the atmosphere thickness above Iraqaccording
to this study, it is concluded that atmosphere thickness above Iraq increases
towards south with an average of 100 M as compared with north of Iraq. Regarding the
temporal variations, it is concluded that atmosphere thickness during hot months. In July, for
example, the atmosphere thickness becomes thicker than in January with an average of
(250)M
A factorial experiment (2× 3) in randomized complete block design (RCBD) with three replications was conducted to examine the effect of honeycomb selection method using three interplant distances on yield and its components of two cultivars of bean, Bronco and Strike. Interplant distances used were 75× 65 cm, 90× 78 cm, and 105× 91 cm (row× plant) represent short (high plant density), intermediate (intermediate plant density), and wide (low plant density) distance, respectively. Parameters used for selection were number of days from planting to the initiation of first flower, number of nodes formed prior to first flower, and number of main branches. Results showed significant superiority of the Bronco cultivar represented in the number
... Show More
The primary objective of this study is to examine the effects of a do-it-yourself (DIY) technique on the reading comprehension performance of fifth-grade students in preparatory schools. In order to accomplish the objective of this research, it is posited that a null hypothesis can be established, suggesting that there are no statistically significant disparities between the average scores of the experimental group, which is instructed using a do-it-yourself (DIY) strategy, and the control groups, which are instructed using a prescribed method, in terms of their reading comprehension attainment. Developing a pre- and post-achievement test. Both groups have been equalized in terms of characteristics such as parental educational leve
... Show MoreThis research aims to Presented model can be applicable – in the frame of current accounting implementations - to measure environmental effects and disclosure then in the financial statements of economic entities after determined the environmental performance scopes of environmental activities that is works by this entities , because of importance of accounting information which presentation by accounting systems which's effectiveness tool on hand of decision maker about site plans and goals and drawing policies aims protection environment sustainable the represented of naturalism wealth elements . The researcher could be able to application his suggested model which's proof the ability to environmental accounting measurement and discl
... Show More
(1)
|
The prevalence of gastrointestinal symptoms of COVID-19 is variable with different types of presentations. Some of them many present with manifestations mimicking surgical emergencies. Yet, the pathophysiology of acute abdomen in the context of COVID-19 remains unclear. We present a case of a previously healthy child who presented with acute appendicitis with multisystemic inflammatory syndrome. We also highlight the necessity of considering the gastrointestinal symptoms of COVID-19 infection in pediatric patients in order to avoid misdiagnosis and further complications. |
The spread of novel coronavirus disease (COVID-19) has resulted in chaos around the globe. The infected cases are still increasing, with many countries still showing a trend of growing daily cases. To forecast the trend of active cases, a mathematical model, namely the SIR model was used, to visualize the spread of COVID-19. For this article, the forecast of the spread of the virus in Malaysia has been made, assuming that all Malaysian will eventually be susceptible. With no vaccine and antiviral drug currently developed, the visualization of how the peak of infection (namely flattening the curve) can be reduced to minimize the effect of COVID-19 disease. For Malaysians, let’s ensure to follow the rules and obey the SOP to lower the
(9)
(3)
Silica-based mesoporous materials are a class of porous materials with unique characteristics such as ordered pore structure, large surface area, and large pore volume. This review covers the different types of porous material (zeolite and mesoporous) and the physical properties of mesoporous materials that make them valuable in industry. Mesoporous materials can be divided into two groups: silica-based mesoporous materials and non-silica-based mesoporous materials. The most well-known family of silica-based mesoporous materials is the Mesoporous Molecular Sieves family, which attracts attention because of its beneficial properties. The family includes three members that are differentiated based on their pore arrangement. In this review,
... Show More
(1)