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 cross-sectional, questionnaire-based study evaluated the knowledge, attitude and practice towards breast cancer and breast self-examination [BSE] among 387 [302 females and 85 males] educated Iraqis affiliated to 2 Iraqi universities. The participants were categorized into 3 occupations: student [71.3%], teaching staff [10.3%] and administrative staff [18.3%]. About half of the participants had a low knowledge score [< 50%]; only 14.3% were graded as [Good] and above. Almost 75% of the participants believed that the best way to control breast cancer was through early detection and other possible preventive measures. Most participants [90.9%] had heard of BSE, the main source of informatio
... Show MoreBiomarkers such as Interleukin-6 (IL-6), Procalcitonin (PCT), C-reactive protein (CRP) and Neutrophil-Lymphocyte Ratio (NLR) have a role in the pathogenesis of severe coronavirus disease 2019 (COVID-19). The aim of this study was to explore the differences between serum levels of such biomarkers in severe and non-severe COVID-19 cases and compare them with normal people and to evaluate the sociodemographic variables and chronic diseases effect on the severity of COVID-19. The study included 160 subjects, divided into two groups, a case group of 80 patients, and a control group of 80 normal persons. The case group was divided into two subgroups: 40 severe COVID-19 patients and 40 patients with non-severe disease. Blood IL-6 was asses
... Show MoreThe absorption spectrum for three types of metal ions in different concentrations has been studying experimentally and theoretically. The examination model is by Gaius model in order to find the best fitting curve and the equation controlled with this behavior. The three metal ions are (Copper chloride Cu+2, Iron chloride Fe+3, and Cobalt chloride Co+2) with different concentrations (10-4, 10-5, 10-6, 10-7) gm/m3. The spectroscopic study included UV-visible and fluorescence spectrum for all different concentrations sample. The results refer to several peaks that appear from the absorption spectrum in the high concentration of all metal ions solution.
... Show MoreAs the reservoir conditions are in continuous changing during its life, well production rateand its performance will change and it needs to re-model according to the current situationsand to keep the production rate as high as possible.Well productivity is affected by changing in reservoir pressure, water cut, tubing size andwellhead pressure. For electrical submersible pump (ESP), it will also affected by numberof stages and operating frequency.In general, the production rate increases when reservoir pressure increases and/or water cutdecreases. Also the flow rate increase when tubing size increases and/or wellhead pressuredecreases. For ESP well, production rate increases when number of stages is increasedand/or pump frequency is
... Show MoreRadon is the most dangerous natural radioactive component affecting the human population, since it is a radioactive gas that results from the decomposition process of uranium deposits in soil, rocks, and water, and it is damaging both humans and the ecosystem. The radon concentrations and exhalation rate in soil samples from various locations were determined using a passive approach with a CR-39 (CR-39 is Columbia Resin #39; it is allyl diglycol carbonate C12H18O7) detector in Amiriya region in Baghdad Governorate. The average values of radon concentrations are ranged from 47.3 to 54.2 Bq·m−3. From the obtained results, we can conclude that the values of all studied locations are
A novel demountable shear connector for precast steel‐concrete composite bridges is presented. The connector uses high‐strength steel bolts, which are fastened to the top flange of the steel beam with the aid of a special locking nut configuration that prevents slip of bolts within their holes. Moreover, the connector promotes accelerated construction and overcomes typical construction tolerances issues of precast structures. Most importantly, the connector allows bridge disassembly, and therefore, can address different bridge deterioration scenarios with minimum disturbance to traffic flow, i.e. (i) precast deck panels can be rapidly uplifted and replaced; (ii) connectors can be rapidly removed and replaced; and (iii) steel beams can b
... Show MoreAbstract Background: The novel coronavirus 2 (SARS?CoV?2) pandemic is a pulmonary disease, which leads to cardiac, hematologic, and renal complications. Anticoagulants are used for COVID-19 infected patients because the infection increases the risk of thrombosis. The world health organization (WHO), recommend prophylaxis dose of anticoagulants: (Enoxaparin or unfractionated Heparin for hospitalized patients with COVID-19 disease. This has created an urgent need to identify effective medications for COVID-19 prevention and treatment. The value of COVID-19 treatments is affected by cost-effectiveness analysis (CEA) to inform relative value and how to best maximize social welfare through evidence-based pricing decisions. O
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In view of the fact that high blood pressure is one of the serious human diseases that a person can get without having to feel them, which is caused by many reasons therefore it became necessary to do research in this subject and to express these many factors by specific causes through studying it using (factor analysis).
So the researcher got to the five factors that explains only 71% of the total variation in this phenomenon is the subject of the research, where ((overweight)) and ((alcohol in abundance)) and ((smoking)) and ((lack of exercise)) are the reasons that influential the most in the incidence of this disease.
Background: A Temporomandibular joint (TMJ) internal derangement (TMJID) is a disruption within the internal aspects of the TMJ in which the disc is displaced from its normal functional relationship with the mandibular condyle, after which the articular portion of the temporal bone causes joint dysfunction, joint sound, malocclusion, and locking of the mouth. Conservative and invasive techniques can be used for the treatment of TMJID. A platelet-rich plasma (PRP) injection is a simple, less invasive surgical procedure for the treatment of internal derangement. The objective of this study was to evaluate the efficacy of PRP injections in decreasing or eliminating pain, clicking, and limitation of mouth opening in patients with TMJID after th
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