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 nanostructured MnO2 /carbon fiber (CF) composite electrode was prepared using the anodic electrodeposition process. The crystal structure and morphology of MnO2 particles were determined with X-ray diffraction and field-emission scanning electron microscopy. The electrosorptive properties of the prepared electrode were investigated in the removal of cadmium ions from aqueous solution, and the effect of pH, cell voltage, and ionic strength was optimized and modeled using the response surface methodology combined with Box–Behnken design. The results confirm that the optimum conditions to remove Cd(II) ions were: pH of 6.03, a voltage of 2.77 V, and NaCl concentration of 3 g/L. The experimental results showed a good fit for the Freundli
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The research objectives, to build a measure of the level of tactical performance of volleyball players applying for the Iraqi Premier League for the 2018-2019 season. The nature of the research problem, then the researchers determined the research sample in the deliberate manner of the players of the Iraqi clubs for the Premier League (B, A). The researchers adopted the entire community as a sample for the research, and the number (156) players distributed over (13) clubs and divided the sample into (12)players an exploratory experiment player representing (the police club) and (100) player representing the construction sample and after a maximum period of two months has passed since applying the scale to the construction sample the researc
... Show MoreWitch stories are part of American popular culture, and this culture is extremely influenced by a continuing reliance on its past. The modern obsession of Americans with witches, whether real or metaphorical, is related to politics especially when it came to issues of gender politics. This article exposes a modern image of the female character seen from a male author point of view. John Updike, influenced by the changes that happened to women within second wave of feminism, attempted to write The Witches of Eastwick (1984). Actually, he presented women who did have a sort of careers. His witches are professional active and dynamic. What do witches stand for in American Culture? Why did Updike choose to write
... Show MoreBackground : Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy of upper extremities and Open carpal tunnel release is the most frequent surgical procedure and the gold standard for cases that do not respond to conservative treatment. Aims :This study is used to evaluate the functional outcome of limited palmar mini-incision of carpal tunnel release. This study aims to determine the safety and symptomatic and functional efficacy of median nerve decompression with limited incision in carpal tunnel syndrome surgery. Patients and methods:Carpal tunnel release with a 1.5-2 cm limited palmar incision was performed on 20 patients. Patients were evaluated initially at one month after treatment according to symptom severity
... Show MoreThe densities and visconsities of solutions of poly(vinyl alcohol)(PVA) molccuar weight (14)kg.mol-1in water up to 0.035%mol.kg-1
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BN RASHİD, 2023
Sequence covering array (SCA) generation is an active research area in recent years. Unlike the sequence-less covering arrays (CA), the order of sequence varies in the test case generation process. This paper reviews the state-of-the-art of the SCA strategies, earlier works reported that finding a minimal size of a test suite is considered as an NP-Hard problem. In addition, most of the existing strategies for SCA generation have a high order of complexity due to the generation of all combinatorial interactions by adopting one-test-at-a-time fashion. Reducing the complexity by adopting one-parameter- at-a-time for SCA generation is a challenging process. In addition, this reduction facilitates the supporting for a higher strength of
... Show MoreA nano-sensor for nitrotyrosine (NT) molecule was found by studying the interactions of NT molecule with new B24N24 nanocages. It was calculated using density functionals in this case. The predicted adsorption mechanisms included physical and chemical adsorption with the adsorption energy of −2.76 to −4.60 and −11.28 to −15.65 kcal mol−1, respectively. The findings show that an NT molecule greatly increases the electrical conductivity of a nanocage by creating electronic noise. Moreover, NT adsorption in the most stable complexes significantly affects the Fermi level and the work function. This means the B24N24 nanocage can detect NT as a Φ–type sensor. The recovery time was determined to be 0.3 s. The sensitivity of pure BN na
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The major climate changes that have affected the planet in addition to wave the big drought plaguing the study area, including the lack of water for imports Badra River fatigue because of the Iran constructing dams on this river and make use of the waters for the benefitof its territory. The subject of finding sources of water has become available with the possibility of exploiting them in an exemplary manner is one of the key things in order to be exploited somewhere.
The study area was chosen within the eastern border of the province of Wasit within the district of Badra border, an area of (1557.5 km2) almost "to study the characteristics of hydrological and identify possibilities for water harvesting them. In this study was conduct