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.
In this work, varying compositions of SiO2 micro filler were added
with the Polyvinyl Chloride (PVC) and samples have been prepared
using film casting technique. The results have been analyzed and
compared for PVC samples with (1 wt%, 3 wt%, 5 wt% and 10 wt%)
SiO2 micro filler. Mechanical characteristics such as tensile strength,
elongation at break and Young`s modulus were measured for all the
samples, where the tensile strength was increased from 8.39 Mpa for
purified PVC to 16 Mpa for 3% SiO2/PVC composite. Also, thermal
conductivity measurement values illustrated that composite materials
have a good thermal insulation at 10 wt. %, thermal conductivity was
decreased from 0.1684 W/m.
Incremental sheet forming (ISF) process offers a high degree of flexibility in the manufacturing of different sheet parts, which makes it an ideal candidate for prototype parts as well as efficient at fabricating various customized products at low production costs compared to traditionally used processes. However, parts produced in this process exhibit notable geometrical inaccuracy and considerable thickness reduction. In this paper, the single point incremental sheet forming variant of the process has been implemented to manufacture a highly customized cranial implant starting from the computed tomography (CT) scan data of the patient's anatomy. A methodology, from the modeling to the realization of the implant, is presented and discus
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The personal drama in particular, and one of the key elements underlying the dramatic structure to convey ideas and visions presented by the author when writing the text of the dramatic fall after that on the way out the submission form that suits the proposals of the text and processors directorial would push the wheel of dramatic structure to the front. So take the maker of the artwork (writer) undertook the transfer of those events and personalities in art presumed sometimes real and sometimes, in order to enrich the art inspired by the human reality through the ages, and full of its themes and ideas that led to the development experiences of peoples experiences of living. Therefore, we find it important to research in the characters
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Background: periodontitis is a chronic inflammatory disease causing destruction of the tooth supporting structures, initiated by dental plaque and modified by environmental and genetic risk factors. Cyclooxygenase-2 (COX-2) enzyme is responsible for the production of prostaglandin E2, an important mediator in the chronic periodontitis (CP) pathogenesis. Polymorphisms in COX-2 gene have linked to CP in different populations. Aim: To study the association between Cyclooxygenase-2 single nucleotide polymorphism rs689466 (-1195A/G SNP) and chronic periodontitis in a sample of Iraqi population. Methods: One hundred Iraqi subjects divided into two groups: case group consisted of 70 CP patient (35 males and 35 females) with age range 30-55 year
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The health care industry is witnessing an increasing trend in the use of generic medicines because of their presumed low cost compared with innovator medicines. The aim of this study was to determine and compare the performance of the copy drug Osveral®and its innovator drug deferasirox (Exjade®).
A prospective observational study including 223 patients receiving the branded medicine Exjade®and 101 patients receiving the copy Osveral®was carried out. Data were assessed for a 1-year period and included clinical symptoms, serum ferrit
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The one-dimensional, spherical coordinate, non-linear partial differential equation of transient heat conduction through a hollow spherical thermal insulation material of a thermal conductivity temperature dependent property proposed by an available empirical function is solved analytically using Kirchhoff’s transformation. It is assumed that this insulating material is initially at a uniform temperature. Then, it is suddenly subjected at its inner radius with a step change in temperature. Four thermal insulation materials were selected. An identical analytical solution was achieved when comparing the results of temperature distribution with available analytical solution for the same four case studies that assume a constant thermal con
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The aim of this study is to develop a novel framework for managing risks in smart supply chains by enhancing business continuity and resilience against potential disruptions. This research addresses the growing uncertainty in supply chain environments, driven by both natural phenomena-such as pandemics and earthquakes—and human-induced events, including wars, political upheavals, and societal transformations. Recognizing that traditional risk management approaches are insufficient in such dynamic contexts, the study proposes an adaptive framework that integrates proactive and remedial measures for effective risk mitigation. A fuzzy risk matrix is employed to assess and analyze uncertainties, facilitating the identification of disr
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