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 review highlights recent advances in the development and use of eco-friendly polymeric membranes made from polymer blends for treating oily wastewater, a major source of environmental pollution. Among treatment options, membrane separation stands out because of its high efficiency and ability to selectively remove oil from water using semi-permeable barriers. The focus of this review is on polymeric membranes derived from polymer blends, which show improved mechanical strength, thermal stability, and resistance to fouling. Additionally, the role of nanomaterials such as titanium dioxide, graphene oxide, and iron nanoparticles is discussed for their ability to boost membrane porosity, permeability, and oil separation efficiency.
... Show MoreThis article comprehensively examines the history, diagnosis, genetics, diversity, and treatment of SARS-CoV-2. It details the emergence of coronaviruses over the past 50 years, including the coronavirus from 2019 and its subsequent mutations, along with updated information about this virus. This review explains the development and nomenclature of coronaviruses, their cellular invasion through glycoprotein spikes binding to ACE-2 receptors, and the mechanism of cell entry via endocytosis. Diagnosis methods for COVID-19, including nucleic acid amplification, serology, and imaging techniques like chest X-ray and CT scan tests, are discussed. Treatment approaches for COVID-19 are outlined, emphasizing healthcare, antiviral medications like Rem
... Show MoreTraditional accounting takes only one dimension (economic) in calculating the value added of the company, and all other aspects (including environmental and social) are neglected, and despite the emergence of Sustainability Accounting and the interest of companies in preparing sustainability reports, these reports are suffering from many problems, including multiple metrics used in measuring companies (cash, quantity and lavish). In addition, these reports may reach dozens of pages in some companies and this causes the problem (information overload) which affects the qualitative properties of accounting information such as appropriate and relative, which requires the need to find a tool that can measure the Sustainability Unit of
... Show MoreThe research work is "The passive voice as a grammatical phenomenon in four selected textbooks". The research deals with the grammatical phenomenon passive in German. The research consists of two parts, the theoretical and the empirical part. The present research work is divided into 3 sections:
The first section includes the definition of passive, passive types, process passive, state passive, passive with modal verbs, and other types of passive. The second section provides illustrations of the four selected textbooks. The third chapter presents the passive voice in textbooks, namely German language teaching for foreigners by Dora Schulz and Heinz Griesbach, Delfin von Aufderstrasse H. and others, Em von Balme, M. and others and
... Show MoreThe present work deals with five species of parasitic Hymenoptera belonging to Pteromalidae, Eupelmidae and Eurytornidae which have been reared from brachid beetles. A new species, Eurytoma irakensis is described and the species, Bruchocida orientalis Crawford is recorded for the first time from Iraq.
Modeling forward kinematics with neural networks allows for efficient handling of nonlinear relationships and realistic error correction in time-critical applications by relying on accurate training data. This paper presents a Multi-Layer Feed-Forward Neural Network (MLFFNN) to solve the forward kinematics of a 3-DOF robot. The proposed MLFFNN consists of 50 hidden neurons and was trained using 628319 samples to find only the position (x, y, z) of the end-effector. Data were generated by MATLAB, assuming an incremental motion of joints. The joint variables ( , , and ) are the inputs of the NN, which outputs the positions of the end effector (x, y, z) calculated using the Denavit-Hartenberg (DH) method. The results demonstrate that t
... Show MoreThe mediation system is based on settling the dispute amicably through the intervention of a third party by bringing views closer away from the judiciary, which is an amicable way to settle disputes, which disputants resort to voluntarily, but some Western legislation has begun to impose resorting to mediation to settle disputes compulsorily, to take advantage of its advantages, get rid of the disadvantages of resorting to the judiciary in some disputes, and relieve pressure on the courts.
Nearly a century and a half has passed since Sarah Orne Jewett published her much anthologized short story “A White Heron” (1886), but commentators on the tale missed one of the most important points in the text. It is the story’s similarity to the traditional Euro-centric fairy tale of “Little Red Riding Hood”. As an author, writing at the end of the ninetieth century, a time that witnessed the demise of the Romantic movement in America and the beginning of the age of Realism, Jewett did not romanticize her characters, despite the idyllic landscape in which “A White Heron” is set. Her story can be analyzed as a text that aims at disseminating ecological awareness among her young readers. This study focuses on Jewett
... Show MoreRoller Compacted Concrete is a type of concrete that is environmentally friendly and more economical than traditional concrete. Roller Compacted Concrete is typically used for heavy-duty and specialist constructions, such as hydraulic structures and pavements, because of its coarse surface. The main difference between RCC and conventional concrete mixtures is that RCC has a more significant proportion of fine aggregates that allow compaction and tight packing. In recent years, it has been estimated that several million tons of waste demolished material (WDM) produced each year are directed to landfills worldwide without being recycled for disposal. This review aimed to study the literature about creating a Roller-Comp
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