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: The majorities of statin-treated patients, in whom low-density lipoprotein cholesterol (LDL-C) targets have been achieved, have had recurrent cardiovascular events (CVE) with an absolute rate remain even higher among patients with disorders of insulin resistance, metabolic syndrome (MetS) and type2 diabetes mellitus (T2DM) as compared to patients devoid of these conditions.Objectives: Provide updated key messages of lipid and lipoprotein abnormalities as indicator for cardiovascular disease (CVD) risk in patients with T2DM and obesity, as well as the current evidence-based treatment targets and interventions to reduce this risk.Key messages: The Residual Risk Reduction Initiative (R3I) emphasized atherogenic dyslipidemia (AD)
... Show MoreThe alfalfa plant, after harvesting, was washed, dried, and grinded to get fine powder used in water treatment. We used the alfalfa plant with ethanol to make the alcoholic extract characterized by using (GCMass, FTIR, and UV) spectroscopy to determine active compounds. Alcoholic extract was used to prepare zinc nanoparticles. We characterized Zinc nanoparticles using (FTIR, UV, SEM, EDX Zeta potential, XRD, AFM). Zinc nanoparticle with Alfalfa extract and alfalfa powder were used in the treatment of water polluted with inorganic elements such as Cr, Mn, Fe, Cu, Cd, Ag by (Batch processing). The batch process with using alfalfa powder gets treated with Pb (51.45%), which is the highest percentage of treatment. Mn (13.18%), which is the lowe
... Show MoreIron is one of the abundant elements on earth that is an essential element for humans and may be a troublesome element in water supplies. In this research an AAN model was developed to predict iron concentrations in the location of Al- Wahda water treatment plant in Baghdad city by water quality assessment of iron concentrations at seven WTPs up stream Tigris River. SPSS software was used to build the ANN model. The input data were iron concentrations in the raw water for the period 2004-2011. The results indicated the best model predicted Iron concentrations at Al-Wahda WTP with a coefficient of determination 0.9142. The model used one hidden layer with two nodes and the testing error was 0.834. The ANN model coul
... Show MoreTwo types of adsorbents were used to treat oily wastewater, activated carbon and zeolite. The removal efficiencies of these materials were compared to each other. The results showed that activated carbon performed some better properties in removal of oil. The experimental methods which were employed in this investigation included batch and column studies. The former was used to evaluate the rate and equilibrium of carbon and zeolie adsorption, while the latter was used to determine treatment efficiencies and performance characteristics. Expanded bed adsorber was constructed in the column studies. In this study, the adsorption behavior of vegetable oil (corn oil) onto activated carbon and zeolite was examined as a function of the concentr
... Show MoreThe present study dealt with the removal of methylene blue from wastewater by using peanut hulls (PNH) as adsorbent. Two modes of operation were used in the present work, batch mode and inverse fluidized bed mode. In batch experiment, the effect of peanut hulls doses 2, 4, 8, 12 and 16 g, with constant initial pH =5.6, concentration 20 mg/L and particle size 2-3.35 mm were studied. The results showed that the percent removal of methylene blue increased with the increase of peanut hulls dose. Batch kinetics experiments showed that equilibrium time was about 3 hours, isotherm models (Langmuir and Freundlich) were used to correlate these results. The results showed that the (Freundlich) model gave the best fitting for adsorption capacity. D
... Show MoreThis study aims to establish an empirical correlation between biochemical oxygen demand (BOD5) and chemical oxygen demand (COD) of the sewage flowing in Al-Diwaniyah wastewater treatment plant. The strength of the wastewater entering the plant varied from medium to high. High concentrations of BOD5 and COD in the effluent were obtained due to the poor performance of the plant. This was observed from the BOD5 /COD ratios that did not confirm with the typical ratios for the treated sewage. To improve the performance of this plant, regression equations for BOD5 and COD removal percentages were suggested which can be used to facilitate rapid effluent assessment or optimal process control. The equations relating the percentage removal of
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This study aimed to improve the microencapsulation technique using a type coating the encapsulation Layer by Layer, which provide the best protection for life Lactobacillus casei in the extrusion method and use the microencapsulation of materials of the protein concentrated by protein 80% and the coating with alginate and chitosan have the results showed the variation in the difference of the binding process encapsulation yield among the types of coating through. by studying of these the effect o stability of the bio probiotic free cell and the three types coated towards three different concentrations from bile salts 0, 0.3, 0.5 and 0.7% when the periods of time different of zero and two and three hours at incubation the recorded
... Show MoreThe electrocoagulation process became one of the most important technologies used for water treatment processes in the last few years. It’s the preferred method to remove suspended solids and heavy metals from water for treating drinking water and wastewater from textile, diary, and electroplating factories. This research aims to study the effect of using the electrocoagulation process with aluminum electrodes on the removal efficiency of suspended solids and turbidity presented in raw water and optimizing by the response surface methodology (RSM). The most important variables studied in this research included electrode spacing, the applied voltage, and the operating time of the electrocoagulation process. The samples
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