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.
Diverting river flow during construction of a main dam involves the construction of cofferdams, and tunnels, channels or other temporary passages. Diversion channels are commonly used in wide valleys where the high flow makes tunnels or culverts uneconomic. The diversion works must form part of the overall project design since it will have a major impact on its cost, as well as on the design, construction program and overall cost of the permanent works. Construction costs contain of excavation, lining of the channel, and construction of upstream and downstream cofferdams. The optimization model was applied to obtain optimalchannel cross section, height of upstream cofferdam, and height of downstream cofferdamwith minimum construction cost
... Show MoreMethylotrophs bacteria are ubiquitous, and they have the ability to consume single carbon (C1) which makes them biological conversion machines. It is the first study to find facultative methylotrophic bacteria in contaminated soils in Iraq. Conventional PCR was employed to amplify MxaF that encodes methanol dehydrogenase enzyme. DNA templates were extracted from bacteria isolated from five contaminated sites in Basra. The gene specific PCR detected Methylorubrum extorquens as the most dominant species in these environments. The ability of M. extorquens to degrade aliphatic hydrocarbons compound was tested at the laboratory. Within 7 days, gas chromatographic (GC) studies of remaining utilize
... Show MoreNiO nanoparticle synthesis by chemical method and characterized by XRD with crystal size 11.72
nm and grain size 13 nm from FESEM image also NiO micro used ,two NiO as an additive to evaluate the
possibility of producing photodegradable polymers, the practical application of solid-phase photocatalytic
degradation of polyvinyl chloride (PVC- NiO composite films) was investigated. PVC has a negative impact
on the environment since its polymer degrades slowly, yet it has a wide range of industrial applications and
the amount used shows no evidence of diminishing use. Thus, a synthesis of modified PVC- NiO micro and
nano has been studied with 0, 50, 100, 150, 200, 250, and 300 (hours) as irradiation time a
ABSTRACTBackground: Concerns about hepatitis A infections is increasing worldwide specially after improving economic and sanitary conditions in many countries making older age groups who escape infection on early life vulnerable to infection.Objectives: The objectives were to estimate the frequency of hepatitis A among children consulting Al Alwyia pediatric Teaching Hospital during the year 2013 and to study some demographic characteristics of the disease.Methods: This cross - sectional hospital -based study wasconducted during 2013-2014 and include pediatric patients(43525 patients) who consult Al Alwyia pediatric hospitalduring that time. The outcome is total IgM antibodies tohepatitis A virus detected using Enzyme Linked FluorescentA
... Show MoreThis paper is concerned with the blow-up solutions of a system of two reaction-diffusion equations coupled in both equations and boundary conditions. In order to understand how the reaction terms and the boundary terms affect the blow-up properties, the lower and upper blow-up rate estimates are derived. Moreover, the blow-up set under some restricted assumptions is studied.
Case Report.
To present a case of a previous complicated mandibular orthognathic surgery that aimed to setback the mandible in a female cleft lip and palate (CLP) patient, which led to bone necrosis on one side with subsequent severe mandibular deviation and facial asymmetry. We additionally reviewed the previous reports of similar complications, the pathophysiology and the factors that could lead to this dreadful result.
A 27-year-old female patient presented with a severe dentofacial deformity secondary to a complicated bilateral sagittal spli
In solar-thermal adsorption/desorption processes, it is not always possible to preserve equal operating times for the adsorption/desorption modes due to the fluctuating supply nature of the source which largely affects the system’s operating conditions. This paper seeks to examine the impact of adopting unequal adsorption/desorption times on the entire cooling performance of solar adsorption systems. A cooling system with silica gel–water as adsorbent-adsorbate pair has been built and tested under the climatic condition of Iraq. A mathematical model has been established to predict the system performance, and the results are successfully validated via the experimental findings. The results show that, the system can be operational
... Show MoreThe meniscus has a crucial function in human anatomy, and Magnetic Resonance Imaging (M.R.I.) plays an essential role in meniscus assessment. It is difficult to identify cartilage lesions using typical image processing approaches because the M.R.I. data is so diverse. An M.R.I. data sequence comprises numerous images, and the attributes area we are searching for may differ from each image in the series. Therefore, feature extraction gets more complicated, hence specifically, traditional image processing becomes very complex. In traditional image processing, a human tells a computer what should be there, but a deep learning (D.L.) algorithm extracts the features of what is already there automatically. The surface changes become valuable when
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