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 surgeryKeywords: Non-surgical treatment of anal fissure, fissure in ano, sphicterotomy,botulinum toxin in anal fissures, glyceryl trinitrate. Chemical sphincteratomy, pharmacological sphincteratomy.
The inflammatory response is a crucial aspect of the tissues’ responses to deleterious inflammogens. This complex response involves leukocytes cells such as macrophages, neutrophils, and lymphocytes, also known as inflammatory cells. In response to the inflammatory process, these cells release specialized substances which include vasoactive amines and peptides, eicosanoids, proinflammatory cytokines, and acute-phase proteins, which mediate the inflammatory process by preventing further tissue damage and ultimately resulting in healing and restoration of tissue function. This review discusses the role of the inflammatory cells as well as their by-products in the mediation of inflammatory process. A brief insight into the role of natural an
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Psidium guajava, belonging to the Myrtaceae family, thrives in tropical and subtropical regions worldwide. This important tropical fruit finds widespread cultivation in countries like India, Indonesia, Syria, Pakistan, Bangladesh, and South America. Throughout its various parts, including fruits, leaves, and barks, guava boasts a rich reservoir of bioactive compounds that have been traditionally utilized as folkloric herbal medicines, offering numerous therapeutic applications. Within guava, an extensive array of Various compounds with antioxidative properties and phytochemical constituents are present, including essential oils, polysaccharides, minerals, vitamins, enzymes, triterpenoids, alkaloids, steroids, glycosides, tannins, fl
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A method has been demonstrated to synthesise effective zeolite membranes from existing crystals without a hydrothermal synthesis step.
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This paper presents a fully computerized method to backup the router configuration file. The method consists of a friendly graphical interface programmed by Java programming language.
The proposed method is compared with the two existing methods, namely: TFTP server method and Copy/Paste method. The comparison reveals that the proposed method has many advantages over the existing ones. The proposed method has been implemented on Cisco routers (series 2500, 2600 and 2800).
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In this work, a CW CO2 laser was used for cutting samples of the fiber-reinforced
plastics (FRP) of three different types of reinforcing material; aramide, glass and carbon.
Cutting process was investigated throughout the variation of some parameters of cutting
process and their effects on cutting quality as well as the effect of an inert gas exist in the
interaction region and finally using a mechanical chopper in order to enhance the cutting
quality. Results obtained explained the possibility to perform laser cutting with high
quality in these materials by good control of the parameters and conditions of the process.
In this paper, the finite element method is used to study the dynamic behavior of the damaged rotating composite blade. Three dimensional, finite element programs were developed using a nine node laminated shell as a discretization element for the blade structure (the same element type is used for damaged and non-damaged structure). In this analysis the initial stress effect (geometric stiffness) and other rotational effects except the carioles acceleration effect are included. The investigation covers the effect speed of rotation, aspect ratio, skew angle, pre-twist angle, radius to length, layer lamination and fiber orientation of composite blade. After modeling a non-damaged rotating composite blade, the work procedure was to ap
... Show More Aluminum alloys widely use in production of the automobile and the aerospace because
they have low density, attractive mechanical properties with respect to their weight, better
corrosion and wear resistance, low thermal coefficient of expansion comparison with traditional
metals and alloys. Recently, researchers have shifted from single material to composite materials
to reduce weight and cost, improve quality, and high performance in structural materials.
Friction stir processing (FSP) has been successfully researched for manufacturing of metal
matrix composites (MMCs) and functional graded materials (FGMs), find out new possibilities
to chemically change the surfaces. It is shown th
It sheds light on the cultural dimension in the decentralized administration experience in Iraq as evaluation tool by adding a new dimension in studying decentralization in addition to the administrative, political and legal dimensions .The proposal of study is that without the civil political culture ,the administrative decentralization in Iraq which remains weak and it may be imposed to a set of problems. - The study includes an introduction, conclusion and a set of political and cultural issues , its components and it may have the political analysis of this culture and its role in determining the movement of the administrative decentralized movement in Iraq post 2003.