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.
Background: Non-atherosclerotic spontaneous coronary artery dissection (SCAD) is defined as a non-traumatic and non-iatrogenic separation of the coronary arterial wall. SCAD is a highly uncommon cause of myocardial infarction (0.1 to 0.4 %).
Case presentation: 40-year-old African American woman, G1T1P0A0L2, with a past medical history of tobacco abuse and obesity who had uncomplicated cesarean section delivery for healthy twins two weeks prior presented with substernal, sudden onset chest pain. The pain radiated to left arm and back, pressure-like, and is associated with nausea, vomiting, and dyspnea.
On examination she was within normal limits except for a well-healed C-section wound. An electrocardiogr
... Show MoreHashimoto Thyroiditis (HT) is the most common autoimmune thyroid disease and the commonest cause ofhypothyroidism. C-reactive protein (CRP) is synthesized in hepatocyte in response to autoimmune disorders;strongly induced by IL-6. This study aimed to estimate serum IL-6 and CRP levels in autoimmune and non-autoimmune hypothyroidism. The present study included 60 Iraqi female hypothyroid patients divided to 30autoimmune and 30 non-autoimmune, with age ranged between 24-50 years and 30 healthy controls withage ranged between 27-52 years. Serum samples were collected from study groups. The levels of thyroidhormones (TSH, T4 and T3) were determined by using automated Chemiluminescence Immunoassay (CLIA)analysis system. Detection the levels of t
... Show MoreThis research is devoted to investigate relationship between both Ultrasonic Pulse Velocity and Rebound Number (Hammer Test) with cube compressive strength and also to study the effect of steel reinforcement on these relationships.
A study was carried out on 32 scale model reinforced concrete elements. Non destructive testing campaign (mainly ultrasonic and rebound hammer tests) made on the same elements. About 72 concrete cubes (15 X 15 X15) were taken from the concrete mixes to check the compressive strength.. Data analyzed.Include the possible correlations between non destructive testing (NDT) and compressive strength (DT) Statistical approach is used for this purpose. A new relationships obtained from correlations results is give
Recently, research has focused on non-thermal plasma (NTP) technologies as a way to remove volatile organic compounds from the air stream, due to its distinctive qualities, which include a quick reaction at room temperature. In this work, the properties of the plasma generated by the dielectric barrier discharge (DBD) system and by a glass insulator were studied. Plasma was generated at different voltages (3, 4, 6, 7, 8 kV ) with a fixed distance between the electrodes of 5 mm, and a constant argon gas flow rate of (2.5) I/min. DBD plasma emission spectra were recorded for each voltage. The Boltzmann plot method was used to calculate the electron temperature in the plasma ( ), and the Stark expansion method was used to calculate the elec
... Show MoreNon-thermal (low-temperature) plasma may act as an alternative approach to control superficial wound and skin infections when the effectiveness of chemical agents is weak due to natural pathogen or biofilm resistance. In this paper an atmospheric pressure plasma needle jet device which generates a cold plasma jet is used to measure the effectiveness of plasma treatment against different pathogenic bacteria and to test the individual susceptibility of pathogenic bacteria to non-thermal argon plasma. It is found that, Gram-negative bacteria were more susceptible to plasma treatment than Gram-positive bacteria. For the Gram-negative bacteria Pseudomonas aeruginosa, there were no survivors among the initial 1x108C.F.U (Co
... Show MoreThis paper is concerned with introducing and studying the first new approximation operators using mixed degree system and second new approximation operators using mixed degree system which are the core concept in this paper. In addition, the approximations of graphs using the operators first lower and first upper are accurate then the approximations obtained by using the operators second lower and second upper sincefirst accuracy less then second accuracy. For this reason, we study in detail the properties of second lower and second upper in this paper. Furthermore, we summarize the results for the properties of approximation operators second lower and second upper when the graph G is arbitrary, serial 1, serial 2, reflexive, symmetric, tra
... Show MoreDyes are extensively water-soluble and toxic chemicals. The disposing of wastewater rich with such chemicals has severely impacted surface water quality (rivers and lakes). In the current study, an anionic dye, methyl orange, were extracted from wastewater fluids using bulk liquid membranes supplemented with an anionic carrier (Aliquat 336 (QCI)). Parameters including solvent type (carbon tetrachloride and chloroform), membrane stirring speed (100-250 rpm), mixing speed of both phases (50-100 rpm), The feed pH (2-12) and implemented temperature (35-60 °C) were thoroughly analyzed to determine the effect of such variables on extraction effectiveness. Furthermore, the effect of methyl orange (10-50 ppm) in the feed stage and NaOH (0
... Show MoreWater quality sensors have recently received a lot of attention due to their impact on human health. Due to their distinct features, environmental sensors are based on carbon quantum dots (CQDs). In this study, CQDs were prepared using the electro-chemical method, where the structural and optical properties were studied. These quantum dots were used in the environmental sensor application after mixing them with three different materials: CQDs, Alq3 polymer and CQDs and Alq3 solutions using two different methods: drop casting and spin coating, and depositing them on silicon. The sensitivity of the water pollutants was studied for each case of the prepared samples after measuring the change in resistance of the samples at a temperature of
... Show MoreActivated carbon prepared from date stones by chemical activation with ferric chloride (FAC) was used an adsorbent to remove phenolic compounds such as phenol (Ph) and p-nitro phenol (PNPh) from aqueous solutions. The influence of process variables represented by solution pH value (2-12), adsorbent to adsorbate weight ratio (0.2-1.8), and contact time (30-150 min) on removal percentage and adsorbed amount of Ph and PNPh onto FAC was studied. For PNPh adsorption,( 97.43 %) maximum removal percentage and (48.71 mg/g) adsorbed amount was achieved at (5) solution pH,( 1) adsorbent to adsorbate weight ratio, and (90 min) contact time. While for Ph adsorption, at (4) solution pH, (1.4) absorbent to adsorbate weight ratio, and (120 min) contact
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