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.
The Environmental Data Acquisition Telemetry System is a versatile, flexible and economical means to accumulate data from multiple sensors at remote locations over an extended period of time; the data is normally transferred to the final destination and saved for further analysis.
This paper introduces the design and implementation of a simplified, economical and practical telemetry system to collect and transfer the environmental parameters (humidity, temperature, pressure etc.) from a remote location (Rural Area) to the processing and displaying unit.
To get a flexible and practical system, three data transfer methods (three systems) were proposed (including the design and implementation) for rural area services, the fi
... Show MoreThe research aims to present a proposed strategy for the North Oil Company, and the proposed strategy took into account the surrounding environmental conditions and adopted in its formulation on the basis and scientific steps that are comprehensive and realistic, as it covered the main activities of the company (production and exploration activities, refining and refining activities, export and transport of oil, research and development activity, financial activity, information technology, human resources) and the (David) model has been adopted in the environmental analysis of the factors that have been diagnosed according to a
... Show MoreThe current research aims through its chapters to verify the relationship and impact of strategic leadership as an independent variable in the marketing performance as a respondent variable, in a leap cement plant, and try to come up with a set of recommendations that contribute to enhancing the practice and adoption of the two variables in the organization under discussion. And based on the importance of the research topic to the community, and to the researched organization and its members, the analytical and analytical approach was adopted in the completion of this research, and the research community included a leap cement plant in Anbar Governorate, while the research sample was represented by (department heads, and people o
... Show MoreSoils that cause effective damages to engineer structures (such as pavement and foundation) are called problematic or difficult soils (include collapsible soil, expansive soil, etc.). These damages occur due to poor or unfavorited engineering properties, such as low shear strength, high compressibility, high volume changes, etc. In the case of expansive soil, the problem of the shrink-swell phenomenon, when the soil reacts with water, is more pronounced. To overcome such problems, soils can be treated or stabilized with many stabilization ways (mechanical, chemical, etc.). Such ways can amend the unfavorited soil properties. In this review, the pozzolanic materials have been selected to be presented and discussed as chem
... Show MoreIn this paper, an Integral Backstepping Controller (IBC) is designed and optimized for full control, of rotational and translational dynamics, of an unmanned Quadcopter (QC). Before designing the controller, a mathematical model for the QC is developed in a form appropriate for the IBC design. Due to the underactuated property of the QC, it is possible to control the QC Cartesian positions (X, Y, and Z) and the yaw angle through ordering the desired values for them. As for the pitch and roll angles, they are generated by the position controllers. Backstepping Controller (BC) is a practical nonlinear control scheme based on Lyapunov design approach, which can, therefore, guarantee the convergence of the position tracking
... Show MorePsidium guajava, belonging to the Myrtaceae family, thrives in tropical and subtropical regions worldwide. This important tropical fruit finds widespread cultivation in countries like India, Indonesia, Syria, Pakistan, Bangladesh, and South America. Throughout its various parts, including fruits, leaves, and barks, guava boasts a rich reservoir of bioactive compounds that have been traditionally utilized as folkloric herbal medicines, offering numerous therapeutic applications. Within guava, an extensive array of Various compounds with antioxidative properties and phytochemical constituents are present, including essential oils, polysaccharides, minerals, vitamins, enzymes, triterpenoids, alkaloids, steroids, glycosides, tannins, fl
... Show MoreEpithelial mesenchymal transition (EMT) is a process comprising cellular and molecular events which result in cells shifting from an epithelial to a mesenchymal phenotype. Periodontitis is a destructive chronic disease of the periodontium initiated in response to a dysbiotic microbiome, and dominated by Gram-negative bacteria in the subgingival niches accompanied by an aberrant immune response in susceptible subjects. Both EMT and periodontitis share common risk factors and drivers, including Gram-negative bacteria, excess inflammatory cytokine production, smoking, oxidative stress and diabetes mellitus. In addition, periodontitis is characterized by down-regulation of key epithelial markers such as E-cadherin together with up-regulation of
... Show MoreStatement of the Problem. The use of orthodontic fixed appliances may adversely affect oral health leading to demineralizing lesions and the development of gingival problems. Aims of the Study. The study aimed to coat orthodontic archwires with chlorhexidine hexametaphosphate nanoparticles (CHX-HMP NPs) and to evaluate the elusion of CHX from CHX-HMP NPs. Materials and Methods. A solution of CHX-HMP nanoparticles with an overall concentration of 5 mM for both CHX and HMP was prepared, characterized (using atomic force microscope and Fourier transformation infrared spectroscopy), and used to coat orthodontic stainless steel (SSW) and NiTi archwires (NiTiW). The coated segments were characterized (using scanning electron microscopy
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