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.
This research includes a detailed morphological description of the Pollenia mesopotamica sp. nov. in Iraq. Locality, host plant and data of collection were given.
A solar updraft tower power plant (solar tower) is a solar thermal power plant that utilizes a combination of solar
air collector and central updraft tube to generate an induced convective flow which drives pressure staged turbines to generate electricity.
This paper presents practical results of a prototype of a solar chimney with thermal mass, where the glass surface is replaced by transparence plastic cover. The study focused on chimney's basements kind effect on collected air temperatures. Three basements were used: concrete, black concrete and black pebbles basements. The study was conducted in Baghdad from August to November 2009.
The results show that the best chimney efficiency attaine
... Show MoreIn the recent years the research on the activated carbon preparation from agro-waste and byproducts have been increased due to their potency for agro-waste elimination. This paper presents a literature review on the synthesis of activated carbon from agro-waste using microwave irradiation method for heating. The applicable approach is highlighted, as well as the effects of activation conditions including carbonization temperature, retention period, and impregnation ratio. The review reveals that the agricultural wastes heated using a chemical process and microwave energy can produce activated carbon with a surface area that is significantly higher than that using the conventional heating method.
Simulation of free convection heat transfer in a square enclosure induced by heated thin plate is represented numerically. All the enclosure walls have constant temperature lower than the plate’s temperature. The flow is assumed to be two-dimensional. The discretized equations were solved stream function, vorticity, and energy equations by finite difference method using explicit technique and Successive Over- Relaxation method. The study was performed for different values of Rayleigh number ranging from 103 to 105 for different angle position of heated thin plate(0°, 45°, 90°). Air was chosen as a working fluid (Pr = 0.71). Aspect ratio of center of plate to the parallel left wall A2
... Show MoreThe influence of an aortic aneurysm on blood flow waveforms is well established, but how to exploit this link for diagnostic purposes still remains challenging. This work uses a combination of experimental and computational modelling to study how aneurysms of various size affect the waveforms. Experimental studies are carried out on fusiform-type aneurysm models, and a comparison of results with those from a one-dimensional fluid–structure interaction model shows close agreement. Further mathematical analysis of these results allows the definition of several indicators that characterize the impact of an aneurysm on waveforms. These indicators are then further studied in a computational model of a systemic blood flow network. This demonstr
... Show MoreTraffic management at road intersections is a complex requirement that has been an important topic of research and discussion. Solutions have been primarily focused on using vehicular ad hoc networks (VANETs). Key issues in VANETs are high mobility, restriction of road setup, frequent topology variations, failed network links, and timely communication of data, which make the routing of packets to a particular destination problematic. To address these issues, a new dependable routing algorithm is proposed, which utilizes a wireless communication system between vehicles in urban vehicular networks. This routing is position-based, known as the maximum distance on-demand routing algorithm (MDORA). It aims to find an optimal route on a hop-by-ho
... Show MoreIn addition to being a novel medication in treating obesity and type 2 diabetes mellitus, tirzepatide is currently being studied to assess its effectiveness and safety on various health parameters, specifically with an emphasis on the neurological field, including sleep medicine and neurodegenerative conditions. In this perspective, we highlight the recent FDA approval of tirzepatide’s use for the treatment of obstructive sleep apnea, with recommendations for future research to extend use in children and adolescents.
The purpose of this study was to investigate the difference in mandibular trauma caused by two mechanisms for the delivery of missile injuries: firearms and improvised explosive devices (IEDs). The data investigated included sex, age, mechanism of injury, and other clinical and radiographic manifestations. Seventy consecutive patients, predominantly male, with a mean age of 28.6 ± 14 years (range 2–60 years) were enrolled: 38 patients (54.3%) sustained mandibular fractures caused by bullet injuries and 32 patients (45.7%) had mandibular fractures caused by IED explosion injuries. The study revealed that the differences in most of the investigated variables were not statistically significant; the only significant differences were the inci
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