When Is Surgery Warranted for Hemorrhoids Necessary
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Building and Operating Sanitary Facilities in Refugee Accommodation in Germany
October 2015 / Building and operating sanitary facilities in refugee View WASH e-paper in web accommodation in Germany browser October 2015 / Special issue Building and operating sanitary facilities in refugee accommodation in Germany The WASH e-paper is an online magazine published at regular intervals in German and English. Each issue takes a closer look at a current key issue in the water, sanitation and hygiene (WASH) sector and related areas. It also provides updates on forthcoming national and international events, highlights current publications and projects, and reports on news from the sector. The WASH e-paper is published by the German Toilet Organization in close cooperation with the WASH Network and the Sustainable Sanitation Alliance. Issue no. 4 This fourth issue of the WASH e-paper is devoted to sanitary facilities in refugee accommodation in Germany against the background of the current situation in Germany. It is in large part based on an internal guidance document from the German Federal Agency for Technical Relief (THW) drawn up in a close partnership between THW and the German Toilet Organization. The aim of this issue is to provide guidance for everyone currently involved in WASH aspects of setting up, managing and/or maintaining refugee accommodation and to enable them adequately to address cultural specificities and requirements for toilet facilities. We hope you enjoying reading this issue. In this issue… 01 Background / current concerns 02 Cultural diversity and specificities 03 Recommendations for building and using sanitary facilities in refugee accommodation 04 Calendar of key WASH events in 2015 / 2016 05 Recent WASH publications 01 Background / Current concerns The Syrian conflict that began in mid-March 2011 and its effects on European refugee policy have faced Germany with formidable challenges as it has begun receiving refugees in 2015. -
Effect of Conservative Nursing Management on Symptoms of Hemorrhoids During Late Pregnancy
IOSR Journal of Nursing and Health Science (IOSR-JNHS) e-ISSN: 2320–1959.p- ISSN: 2320–1940 Volume 8, Issue 5 Ser. I. (Sep-Oct .2019), PP 35-44 www.iosrjournals.org Effect of Conservative Nursing Management on Symptoms of Hemorrhoids during Late Pregnancy 1 2, Donia Ibrahim Mohamed , Inass Kassem Ali Kassem 3 Amera Bekhatroh Rashed 1, 2 (Maternal and Newborn Health Nursing, Faculty of Nursing, Menoufia University, Egypt) 3 Nursing Department, College of Applied Medical Sciences, Jouf University, Qurrayat, Female Branch. Corresponding Author: Donia Ibrahim Mohamed Abstract: Background: Pregnancy predispose to symptomatic hemorrhoids, being the most common ano-rectal disease at these stages. Purpose of the study: was to study the effect of conservative nursing management on symptoms of hemorrhoids during late pregnancy. Design: A quasi- experimental study design with pre and posttests was used (with comparing the study and control groups). A purposive sample of 110 women attending antenatal care visits at MCH centers was selected. Instrument: three instruments.1-Interviewing questionnaires. 2-questionnaire about complain and symptoms of hemorrhoids.3- Assessment sheet about life - style habits. Result revealed that study group’s participants have experienced fewer haemorrhoidal symptoms than the control group’s participants and there were correlation between socio-demographic data, obstetric history and degree of haemorrhoidal symptoms severity. Conclusion: Based on of the current findings, both study hypotheses are accepted. Hypothesis I: Study group participants had experienced significant fewer haemorrhoidal symptoms than the control group’s participants .Hypothesis II: there was correlation between socio-demographic data, obstetric history and degree of haemorrhoidal symptoms severity. -
Anal Health Care Basics
ORIGINAL RESEARCH & CONTRIBUTIONS Special Report Anal Health Care Basics Jason Chang, MD; Elisabeth McLemore, MD, FACS, FASCRS; Talar Tejirian, MD, FACS Perm J 2016 Fall;20(4):15-222 E-pub: 10/10/2016 http://dx.doi.org/10.7812/TPP/15-222 ABSTRACT diseases causing these anal symptoms. For Despite the fact that countless patients suffer from anal problems, there tends to example, although there are many prob- be a lack of understanding of anal health care. Unfortunately, this leads to incorrect lems that can lead to anal pain, one of the diagnoses and treatments. When treating a patient with an anal complaint, the primary most common is an anal fissure, which is goals are to first diagnose the etiology of the symptoms correctly, then to provide an frequently misdiagnosed as hemorrhoidal effective and appropriate treatment strategy. disease.1 The first step in this process is to take an accurate history and physical examination. Important history questions: Specific questions include details about bowel habits, anal hygiene, and fiber supple- • How often do you have a bowel move- mentation. Specific components of the physical examination include an external anal ment? examination, a digital rectal examination, and anoscopy if appropriate. • What is the quality and consistency Common diagnoses include pruritus ani, anal fissures, hemorrhoids, anal abscess of the bowel movement (ie, hard, soft, or fistula, fecal incontinence, and anal skin tags. However, each problem presents watery)? differently and requires a different approach for management. It is of paramount im- • How long do you sit on the toilet? portance that the correct diagnosis is reached. -
Fecal Incontinence an Educational Handout for Patients
Fecal Incontinence An educational handout for patients What are the symptoms of fecal incontinence? Generally, adults don’t experience fecal incontinence except during bouts of severe diarrhea. If you have fecal incontinence, you may have occasional or frequent accidents. There are a range of symptoms: • unable to hold gas What is fecal incontinence? • “silent” leakage of stool during daily activities or Fecal incontinence is the unexpected leakage of stool exertion, or after a meal (feces) or the inability to control bowel movements. • unable to reach the toilet in time It may also be called bowel or anal incontinence. Fecal incontinence can range from the occasional leakage Some people lose a full bowel movement without of a small amount of stool or gas to a complete loss of being aware of it. This may happen at night. Other bowel control. symptoms may also be present: diarrhea, constipation, The ability to control stool discharge (called continence) abdominal discomfort, urinary incontinence, and anal requires normal function of the muscles and nerves itching. of the rectum and anus (see figure). Specialized What causes fecal incontinence? muscles in the wall of the anus are responsible for Fecal incontinence is commonly caused by a change holding stool: the outer in bowel habits (generally diarrhea) and by conditions muscle group (external anal that affect the ability of the rectum and anus to hold sphincter), the inner muscle stool (e.g., weakness of the anal sphincter). The anal group (internal anal muscles and nerves can be damaged by childbirth and sphincter), and the by trauma, including anal surgery and back surgery. -
COLORS 82 - SHIT a Survival Guide
COLORS 82 - SHIT A survival guide Treviso, November 2011. Feces. Excrement. Stool. Poo. Caca. Its name changes but not most people’s reaction to it. Poo is something we ignore or treat with disdain. It repels us. It’s kept behind closed doors and never mentioned in polite company. But in its new issue, Shit. A survival guide, COLORS looks straight down the pan, exploring the truths behind the taboo, and the reasons why we should start to take shit seriously. Today some two-thirds of the world’s population have no toilet or latrine. They relieve themselves at the roadside or in fields, contaminating water sources and food. Over 90% of diarrhea is caused by the contamination of food, water, or fingers with shit, and although diarrhea is just a banal intestinal virus for those with a toilet, every year it kills more people than AIDS, malaria and TB combined. Feces is a weapon of mass destruction and a nightmare of biological pollution, but it is also a fuel and a fertiliser. It can heat, feed, cure. It’s the world’s most underrated resource, and it can save lives. In Butare prison in Rwanda, the inmates’ shit is treated and turned into biogas, which is then used to cook their meals. In New York, the fecal transplants carried out in Dr Brandt's clinic may seem like torture, but they have a 91% success rate in treating Clostridium difficile, an infection that kills 100,000 people a year in the US and Europe alone. So how do you persuade people to start taking shit seriously? How do you encourage them to build a toilet, or dig a pit latrine? Like an ordinary tourist, Virginia Chumacero asks the inhabitants of Aramasi, Bolivia, to give her a tour of their village. -
Features Tsai on Cover
www.chinapost.com.tw Excelsior (Mexico) City Press (South Africa) ■ SATURDAY ■ ■IMPACT JOURNALISM DAY INSIDE TODAY’S WEATHER ■IMPACT JOURNALISM DAY International 2 TV / Comics 13 June 20, 2015 The magic of “solid rain,” a compound based Business 3 Classifieds 11 These packs are charged all day while the on potassium acrylate, is that it can store 300 Commentary 4 Sports 15 8 Fushun Street, Taipei, 104, Taiwan children are at school and are fully charged times its own weight in water without causing Impact Journalism Day 5-12 Local 16 Phone: (02) 2596-9971 ◆ Fax: (02) 2595-7962 when the sun goes down providing much Email: [email protected] North Central South any harm to the environment. need light for doing homework. Page 11 28-35°C 27-35°C 29-33°C Page 10 N T $ 1 5 TAIWAN’S LEADING ENGLISH-LANGUAGE NEWSPAPER SINCE 1 9 5 2 Vol. LXIII No.283 Total Issues 22,883 ‘Time’ features Tsai on cover dential election loss to incumbent be with when we were an opposi- its cover. Magazine calls Tsai frontrunner Ma Ying-jeou galvanized support- tion party,” Tsai said in the ar- Tsai Not Concrete Enough: Hung ers when she asked them “not to ticle, while seeming to refer to the lose heart.” Tsai, who described DPP’s status as opposition party Deputy Legislative Speaker and for ‘Chinese’ democratic leader herself as “quite adventurous,” in the past tense. likely Kuomintang presidential was also shown to have a witty The Time story, however, does candidate Hung Hsiu-chu told BY YUAN-MING CHIAO linary skills by preparing a meal sense of humor. -
DR MATLEY & PARTNERS Surgeons
DR MATLEY & PARTNERS Surgeons 101 Constantiaberg Tel 797 1755 Harfield House, Kingsbury Tel 683 3893 135 Vincent Pallotti Tel 531 0097 ANAL IRRITATION These notes should help you understand how it happens and how to deal with it. What causes anal irritation? The most common cause of anal irritation is inappropriate anal hygiene by the patient. Many documents will blame seepage of faeces and moisture and anal hair. While these may contribute in some patients, they are not, in fact, the primary cause in the majority. Other conditions may contribute, but they are all rare. They include allergies, diabetes, inflammatory bowel disease, worms, eczema and psoriasis and fungal infections. Other causes include fleshy anal skin tags, anal fissure and prolapsing haemorrhoids, however the most common cause is assiduous, over-cleansing of the anus. What is the management? The doctor needs to take an extremely thorough history, especially about the exact details of how you clean your anus. The doctor needs to exclude the less common conditions mentioned above and he would probably need to examine the rectum and possibly the colon with a scope. Once the doctor is satisfied that there is no disease or predisposing abnormality causing your symptoms, then he needs to advise the patient how to treat themselves. “THE ANUS THRIVES ON NEGLECT” This slightly amusing mantra is absolutely correct. Modern behaviour has resulted in over-zealous attempts to avoid infection in our society. This ranges from the extreme hygiene of food we buy, the decline in exposure to pets and other old fashioned sources of community acquired infections. -
User's Manual for Woongjin ' 'Bidet Ba08-Ar/Ae
Specifications Product Name Woongjin bidet Model Name BA08-AR/AE Power rating AC 120V/60Hz Power consumption 850W Power cord 1.2m(47inch) Water pressure 0.11~0.68M Pa(1.0~7.0kgf/㎠ ) USER'S MANUAL FOR WOONGJIN Product BA08-AR 525(W)x500(D)x142(H)mm dimensions BA08-AE 525(W)x530(D)x142(H)mm ‘’BIDET BA08-AR/AE Weight (NET) 6.2~6.8kg ■ Please read this manual for a proper operation of Rear cleansing max. 0.7ℓ /min, nozzle auto cleaning function WOONGJIN BIDET. ■ The strictly precise company, WOONGJIN BIDET, Front cleansing max. 0.7ℓ /min, nozzle auto cleaning function actualizes the 'Quality First' principle. Timing Rear cleansing 1 min, Front cleansing 1 min, Air dryer 2 min The warranty document is enclosed in this manual. Water pressure control Mycom control, 3 level control Warm water Wide (spray range control) 3 level spray range control(Straight-level 1-level 2) cleansing Air + Air and water mixture stream device Water temperature control 4 levels(off: room temperature, low:33℃, medium:36℃, high:39℃) Power consumption of cistern heater 800W Cistern capacity 1ℓ Safety device Bi-metal, temperature sensor, temperature fuse(over heating prevention) Warm air temperature control 3 levels Warm air Timing Air dry 2min dryer Power consumption of dryer heater 180W Safety device Bi-metal, temperature fuse(over heating prevention) Seat heating control(after seating) 4 levels(off: room temperature, low:34℃, medium:37℃, high:40℃) Warm Power consumption of heater 50W seat Safety device Temperature sensor, temperature fuse(over heating prevention) -
MR Defecography for Obstructed Defecation Syndrome
Published online: 2021-07-30 ABDOMINAL RADIOLOGY MR defecography for obstructed defecation syndrome Ravikumar B Thapar, Roysuneel V Patankar1, Ritesh D Kamat, Radhika R Thapar, Vipul Chemburkar Departments of Radiology and 1Surgery, Joy Hospital, Mumbai, Maharashtra, India Correspondence: Dr. Ravikumar B Thapar, 302, Amar Residency, Punjabwadi, ST Road, Deonar, Mumbai ‑ 400 088, Maharashtra, India. E‑mail: [email protected] Abstract Patients with obstructed defecation syndrome (ODS) form an important subset of patients with chronic constipation. Evaluation and treatment of these patients has traditionally been difficult. Magnetic resonance defecography (MRD) is a very useful tool for the evaluation of these patients. We evaluated the scans and records of 192 consecutive patients who underwent MRD at our center between January 2011 and January 2012. Abnormal descent, rectoceles, rectorectal intussusceptions, enteroceles, and spastic perineum were observed in a large number of these patients, usually in various combinations. We discuss the technique, its advantages and limitations, and the normal findings and various pathologies. Key words: Chronic constipation; magnetic resonance defecography; obstructed defecation syndrome; pelvic floor Introduction bleeding after defecation, and a sense of incomplete fecal evacuation.[4] Patients may also resort to digital rectal Constipation has a high prevalence in the general evacuation. Evaluation and treatment of these patients has population and is a cause for significant morbidity. It been difficult. Magnetic resonance defecography (MRD) has been estimated that approximately 10% of the Indian has been shown to demonstrate the structural abnormalities population suffers from constipation.[1] Chronic constipation associated with ODS, and patients with significant structural leads to approximately 2.5 million visits to the physicians abnormalities may benefit from surgical interventions like in the United States annually.[2] Various definitions have stapled transanal resection of rectum (STARR). -
Defecography by Digital Radiography: Experience in Clinical Practice* Defecografia Por Radiologia Digital: Experiência Na Prática Clínica
Gonçalves ANSOriginal et al. / Defecography Article in clinical practice Defecography by digital radiography: experience in clinical practice* Defecografia por radiologia digital: experiência na prática clínica Amanda Nogueira de Sá Gonçalves1, Marco Aurélio Sousa Sala1, Rodrigo Ciotola Bruno2, José Alberto Cunha Xavier3, João Mauricio Canavezi Indiani1, Marcelo Fontalvo Martin1, Paulo Maurício Chagas Bruno2, Marcelo Souto Nacif4 Gonçalves ANS, Sala MAS, Bruno RC, Xavier JAC, Indiani JMC, Martin MF, Bruno PMC, Nacif MS. Defecography by digital radiography: experience in clinical practice. Radiol Bras. 2016 Nov/Dez;49(6):376–381. Abstract Objective: The objective of this study was to profile patients who undergo defecography, by age and gender, as well as to describe the main imaging and diagnostic findings in this population. Materials and Methods: This was a retrospective, descriptive study of 39 patients, conducted between January 2012 and February 2014. The patients were evaluated in terms of age, gender, and diagnosis. They were stratified by age, and continuous variables are expressed as mean ± standard deviation. All possible quantitative defecography variables were evaluated, including rectal evacuation, perineal descent, and measures of the anal canal. Results: The majority (95%) of the patients were female. Patient ages ranged from 18 to 82 years (mean age, 52 ± 13 years): 10 patients were under 40 years of age; 18 were between 40 and 60 years of age; and 11 were over 60 years of age. All 39 of the patients evaluated had abnormal radiological findings. The most prevalent diagnoses were rectocele (in 77%) and enterocele (in 38%). Less prevalent diagnoses were vaginal prolapse, uterine prolapse, and Meckel’s diverticulum (in 2%, for all). -
Guide to Vaginal / Anal Play
Guide To Anal and Vaginal Play for Women and Men Most of the following techniques apply to both vaginal and anal play for women and men. *Bowel Movements – It’s best to have a bowel movement just before or 1-2 hours before, then anal douche with warm water using a 1 cup bulb syringe or enema bag before anal play. Make sure you’re completely evacuated and clean. Learn your cycle, everyone is different but it usually takes 6-8 hours from the time you eat to the time you have a bowel movement and you normally have a bowel movement for each meal you eat. If you eat before anal play make sure it’s a light meal. *Toys – Use only toys made from silicone. Never use toys made from other rubber materials as they leach out harsh chemicals that may cause allergic reactions. Clean your toys with soap and hot water and store them in a clean dry place between use. Never store toys in plastic or air tight containers as this will promote bacteria growth. A cloth bag or pillow case is perfect, then store them in a clean laundry drawer. Heating your toys by soaking them in hot water before use will enhance your experience. *Lube – Use plenty of thick, water based lube, the more the better. We recommend Cinnalube due to it’s hypoallergenic properties, thick consistency, and slipperiness. Use lube both internally and externally, squirt some thick lube, about 5-10cc, into your anal canal using a nozzle tipped syringe prior to anal play. -
Raslan's Notes. Color Index: Notes, Important, Extra
Objectives: Not Given. Resources: ● Davidson’s (Chapter 17 pg 283). ● 436 doctors slides. ● Surgical Recall. ● 435’s teamwork. ● Raslan’s notes. Done by: Yara Aldigi, Khalid Aleedan, Abdulmohsen Alkhalaf Leaders: Heba Alnasser, Jawaher Abanumy, Mohammed Habib, Mohammad Al-Mutlaq Revised by: Maha AlGhamdi Color index: Notes , Important , Extra , Davidson’s Editing file Feedback Note: We mentioned the diseases in the same order as Davidson’s not the slides. Anatomy of the Anal Canal (you have to know the anatomy to understand the diseases) The anal canal is about 3-4 cm long. It consists of 2 concentric muscle layers known as: internal and external sphincters. Internal Sphincter External Sphincter Smooth muscle (involuntary control) Skeletal muscle (voluntary control) Continuation of circular muscle of GI tract (bowel). Blends with lower part of levator ani (puborectalis sling) Mainly for gas continence. Mainly for solid and liquid stool continence. Visceral innervation sensitive to stretch and ischemia Somatic (sensory) innervation sensitive to touch & pain Columnar glandular epithelium Non-keratinized squamous epithelium Derived from endoderm (hindgut) Derived from ectoderm ● Superior rectal (hemorrhoidal) artery (branch of the ● Inferior rectal artery (branch of the internal pudendal inferior mesenteric artery) artery) ● Superior rectal vein → portal circulation. ● Inferior rectal vein → systemic circulation. ● Lymphatic drainage to inferior mesenteric nodes ● Lymphatic drainage to the inguinal nodes. ● The dentate (pectinate) line represents the line of fusion between the endoderm + ectoderm. It separates the anal canal from the anal verge. ● There are almost 15 to 20 glands within the crypts of dentate line. They have ducts that drain their content/debris into the anal canal.