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.
Objective: Comprehending microbial diversity and antibiotic resistance patterns is essential for efficient treatment protocols. This study sought to determine the incidence of bacterial and fungal pathogens responsible for burn and wound infections and their antibiotic susceptibility profiles. Methods: This cross-sectional study involved 140 patients with burn or wound infections. Sterile swabs and pus aspiration were employed to collect samples, which were subsequently processed using standard microbiological procedures. Antibiotic resistance was determined using the Kirby-Bauer disc diffusion method, following Clinical and Laboratory Standards Institute (CLSI) guidelines. Data was analysed using IBM SPSS version 25.0, and the Chi-
... Show MoreObjectives. This study was carried out to quantitatively evaluate and compare the sealing ability of Endoflas by using differentobturation techniques. Materials and Methods. After 42 extracted primary maxillary incisors and canines were decoronated, theircanals were instrumented with K files of size ranging from #15 to #50. In accordance with the obturation technique, the sampleswere divided into three experimental groups, namely, group I: endodontic pressure syringe, group II: modified disposable syringe,and group III: reamer technique, and two control groups. Dye extraction method was used for leakage evaluation. Data wereanalyzed using one-way ANOVA and Dunnett’s T3 post hoc tests. The level of significance was set at p<0:05. Results.
... Show MoreAdvanced strategies for production forecasting, operational optimization, and decision-making enhancement have been employed through reservoir management and machine learning (ML) techniques. A hybrid model is established to predict future gas output in a gas reservoir through historical production data, including reservoir pressure, cumulative gas production, and cumulative water production for 67 months. The procedure starts with data preprocessing and applies seasonal exponential smoothing (SES) to capture seasonality and trends in production data, while an Artificial Neural Network (ANN) captures complicated spatiotemporal connections. The history replication in the models is quantified for accuracy through metric keys such as m
... Show MoreA novel Schiff base (SB) ligand, abbreviated as HDMPM, resulted from the condensation of 2-amino-4-phenyl-5-methyl thiazole and 4-(diethylamino)salicyaldehyde, and its metal complexes with [Co(II), Cu(II), Ni(II), and Zn(II)] ions in high yield were formed. The physico-chemical techniques such as elemental analysis, molar conductance, IR, 1H and 13C NMR, mass spectroscopy, and electronic absorption studies were utilized to characterize the synthesized compounds. The studied compounds were examined for their possible anticancer activity against a number of human cancerous cell lines, including A549 lung carcinoma, HepG2 liver cancer, HCT116 colorectal cancer, and MCF-7 breast cancer cell lines, with doxorubicin serving as the standard. The s
... Show MoreThis work investigates the impacts of eccentric-inclined load on ring footing performance resting on treated and untreated weak sandy soil, and due to the reduction in the footing carrying capacity due to the combinations of eccentrically-inclined load, the geogrid was used as reinforcement material. Ring radius ratio and reinforcement depth ratio parameters were investigated. Test outcomes showed that the carrying capacity of the footing decreases with the increment in the eccentric-inclined load and footing radius ratio. Furthermore, footing tilt and horizontal displacement increase with increasing the eccentricity and inclination angle, respectively. At the same time, the increment in the horizontal displacement due t
... Show MoreThis study numerically intends to evaluate the effects of arc-shaped fins on the melting capability of a triplex-tube confinement system filled with phase-change materials (PCMs). In contrast to situations with no fins, where PCM exhibits relatively poor heat response, in this study, the thermal performance is modified using novel arc-shaped fins with various circular angles and orientations compared with traditional rectangular fins. Several inline and staggered layouts are also assessed to maximize the fin’s efficacy. The effect of the nearby natural convection is further investigated by adding a fin to the bottom of the heat-storage domain. Additionally, the Reynolds number and temperature of the heat-transfer fluid (HTF) are e
... Show MoreIn this study, the energy charging mechanism is mathematically modeled to determine the impact of design modifications on the thermofluidic behavior of a phase change material (PCM) filled in a triplex tube containment geometry. The surface area of the middle tube, where the PCM is placed, is supported by single or multi-internal frustum tubes in vertical triplex tubes to increase the performance of the heating and cooling of the system. In addition to the ordinary straight triplex tubes, three more scenarios are considered: (1) changing the middle tube to the frustum tube, (2) changing the inner tube to the frustum tube, and (3) changing both the internal and central tubes to the frustum tubes. The impact of adopting the tube desig
... Show More