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.
Ruthenium-Ruthenium and Ruthenium–ligand interactions in the triruthenium "[Ru3(μ-H)(μ3-κ2-Hamphox-N,N)(CO)9]" cluster are studied at DFT level of theory. The topological indices are evaluated in term of QTAIM (quantum theory of atoms in molecule). The computed topological parameters are in agreement with related transition metal complexes documented in the research papers. The QTAIM analysis of the bridged core part, i.e., Ru3H, analysis shows that there is no bond path and bond critical point (chemical bonding) between Ru(2) and Ru(3). Nevertheless, a non-negligible delocalization index for this non-bonding interaction is calculated
... Show MoreShort Multi-Walled Carbon Nanotubes functionalized with OH group (MWCNTs-OH) were used to synthesize flexible MWCNTs networks. The MWCNTs suspension was synthesized using Benzoquinone (BQ) and N, N Dimethylformamide alcohol (DMF) in specific values and then deposited on filter paper by filtration from suspension (FFS) method. Polypyrrole (PPy) conductive polymer doped with metallic nanoparticles (MNPs) prepared using in-situ chemical polymerization method. To improve the properties of the MWCNTs networks, a coating layer of (PPy) conductive polymer, PPy:Ag nanoparticles, and PPy: Cu nanoparticles were applied to the network. The fabricated networks were characterized using an X-ray diffractometer (XRD), UV-Vis. spectrometer, and Ato
... Show MoreThis study aims to identify the impact of social support on breast cancer patients’ psychological rigidity using a sample in Ramallah and al-Bireh. A descriptive correlative approach was adopted to fulfill the goals of the study and a questionnaire consisted of two criteria: social support and psychological rigidity, which was adopted as a tool for data collection for the study. In order to achieve the goals of the study, the researcher selected a convenient sample that consisted of 123 female breast cancer patients in Ramallah and al-Bireh. This sample represented 50% of the original patient population. The study showed that the average estimated percentage of social support and psychological rigidity for women with breast cancer, in
... Show MoreIraq suffers from serious pollution with harmful particles that have important direct and indirect effects on human activities and human health. In this research, a system for detecting pollutants in the air was designed and manufactured using infrared laser technology. This system was used to detect the presence of pollutants in the dust storms that swept the city of Baghdad which could have a negative impact on human health and living organisms.
The designed detection system based on the use of infrared laser (IR) with a wavelength of 1064 nm was used for the purposes of detecting pollutants based on the scattering of the laser beam from these pollutants. The system was aligned to obtain the best signal for the scattered rays, w
... Show MoreThis paper reviews the studies on expansive soil with a main focus on failure mechanism, financial losses, mineralogy, determination of swelling parameters and others. Effect of hydrocarbon pollution on geotechnical properties of expansive soil was presented. The paper discussed the assessment of electrical response of contaminated swelling soils. Wide extend of expansive grounds around the world and the serious impact created on infrastructures requires to identify its influential aspects and the appropriate treatments. Also, it was found that petroleum product affect significantly on the basic properties of swelling soils such as gradation, consistency, compaction, swelling and othe
Summary: The study focused on the role of the educational counselor in schools, as an integral part of the educational system that faces multiple challenges and difficulties. In this context, the counselor’s role becomes crucial in attempting to reduce or eliminate such difficulties, in addition to guiding students in an appropriate manner. Methodes: The study employed a descriptive field approach, using interviews and direct observation as tools to examine the actual role performed by school counselors. Results: The study concluded with several key findings, most notably the numerous challenges faced by counselors, including students’ negative behaviors, school dropouts, and the limited administrative support for counselors’ work. Fu
... Show MoreThe objectives of this study were to review the literature covering the perceptions about influenza vaccines in the Middle East and to determine factors influencing the acceptance of vaccination using Health Belief Model (HBM).
A comprehensive literature search was performed utilizing PubMed and Google Scholar databases. Three keywords were used: Influenza vaccine, perceptions and Middle East. Empirical studies that dealt with people/healthcare worker (HCW) perceptio