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.
MRY *Khalid Sh. Sharhan, *Naseer Shukur Hussein, INTERNATIONAL JOURNAL OF DEVELOPMENT IN SOCIAL SCIENCE AND HUMANITIES, 2021
Background: This in vitro study compares a novel calcium-phosphate etchant paste to conventional 37% phosphoric acid gel for bonding metal and ceramic brackets by evaluating the shear bond strength, remnant adhesive and enamel damage following water storage, acid challenge and fatigue loading. Material and Methods: Metal and ceramic brackets were bonded to 240 extracted human premolars using two enamel conditioning protocols: conventional 37% phosphoric acid (PA) gel (control), and an acidic calcium-phosphate (CaP) paste. The CaP paste was prepared from β-tricalcium phosphate and monocalcium phosphate monohydrate powders mixed with 37% phosphoric acid solution, and the resulting phase was confirmed using FTIR. The bonded premolars were exp
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Experimental investigations had been done in this study to demonstrate the effect of natural particles used as a reinforcement material to unsaturated polyester resin. The tensile test and water absorption were investigated according to (ASTM D638) and (ASTM D570), respectively. The influence of sunflower husk and pomegranate husk particles, used as a reinforcement material, on the tensile strength, Young's modulus and water absorption with different weight fraction (3%, 7% and 10%) and particle grain size (50µm, 100 µm and 150 µm), has been investigated. The water absorption of polymer composites was studied by measuring the specimen weight before and after immersion in water for one hundred days. In the experiments of tensile test,
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This study aims to derive a sustainable human development index for the Arab countries by using the principal components analysis, which can help in reducing the number of data in the case of multiple variables. This can be relied upon in the interpretation and tracking sustainable human development in the Arab countries in the view of the multiplicity of sustainable human development indicators and its huge data, beside the heterogeneity of countries in a range of characteristics associated with indicators of sustainable human development such as area, population, and economic activity. The study attempted to use the available data to the selected Arab countries for the recent years. This study concluded that a single inde
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The annual performance of a hybrid system of a flat plate photovoltaic thermal system and a solar thermal collector (PVT/ST) is numerically analyzed from the energy, exergy, and environmental (CO2 reduction) viewpoints. This system can produce electricity and thermal power simultaneously, with higher thermal power and exergy compared to conventional photovoltaic thermal systems. For this purpose, a 3D transient numerical model is developed for investigating the system's performance in four main steps: (1) investigating the effects of the mass flow rate of the working fluid (20 to 50 kg/h) on the temperature behavior and thermodynamic performance of the system, (2) studying the impacts of using glass covers on the different parts of the s
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This study discussed a biased estimator of the Negative Binomial Regression model known as (Liu Estimator), This estimate was used to reduce variance and overcome the problem Multicollinearity between explanatory variables, Some estimates were used such as Ridge Regression and Maximum Likelihood Estimators, This research aims at the theoretical comparisons between the new estimator (Liu Estimator) and the estimators
Background: There are so many evidences that there was antimicrobial resistance, and there were many strains that emerged which were difficult to treat. We are living in a situation that the dissemination of multiple drug resistant bacteria can lead us to the situation, in which no treatment could be offered for bacterial infection in future.
Aim of study: Assessment of nurses’ knowledge, attitude, and practices on antibiotic use and resistance in Fatima Al Zahra hospital in Baghdad.
Subjects and Methods: A cross-sectional study. The study was carried on from 1st of February to 31st of March 2021. A questionnaire was constructed by the research team based on literature review and was adapted to asses
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In this work, a novel technique to obtain an accurate solutions to nonlinear form by multi-step combination with Laplace-variational approach (MSLVIM) is introduced. Compared with the traditional approach for variational it overcome all difficulties and enable to provide us more an accurate solutions with extended of the convergence region as well as covering to larger intervals which providing us a continuous representation of approximate analytic solution and it give more better information of the solution over the whole time interval. This technique is more easier for obtaining the general Lagrange multiplier with reduces the time and calculations. It converges rapidly to exact formula with simply computable terms wit
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