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 surgery Keywords: Non-surgical treatment of anal fissure, fissure in ano, sphicterotomy,botulinum toxin in anal fissures, glyceryl trinitrate. Chemical sphincteratomy, pharmacological sphincteratomy.
The bandwidth requirements of the telecommunication network users increased rapidly during the last decades. Optical access technologies must provide the bandwidth demand for each user.The passive optical
To determine the relationship between infertility and Helicobacter pylori infection, thirty-five infertile patients of ages (20-49) years have been investigated and compared with 10 apparently firtility individuals. All the studied groups were carried out to measure (ASA), (TNF-á), (IL-6), (anti-H.pylori IgA) and (anti-H.pyloriIgG) by Enzyme linked immunosorbent assay (ELISA) technique. The statistical analysis also demonstrated that there were a highly significant differences (P<0.01), when compared between studied group. Also, the statistical analysis demonstrated that there were a highly significant differences (P<0.01) when compare between infertility and fertility in Conc. of sperm. The percentage distribution of ASA in serum and seme
... Show MoreThe aim of this research is to diagnose the attention deficit hyperactivity disorder among primary school pupils in Baquba city of Diyala province. The sample of the study consisted of (25) male and female pupils. The American Guide of Attention Deficit Hyperactivity Scale (DSM-IV, 1994) was used in this study in addition to Conner’s (1996) scale to measure the attention deficit hyperactivity disorder for teachers and parents. The result revealed that (19) male and female pupils diagnosed with attention deficit hyperactivity to various degrees.
Attention-Deficit Hyperactivity Disorder (ADHD), a neurodevelopmental disorder affecting millions of people globally, is defined by symptoms of hyperactivity, impulsivity, and inattention that can significantly affect an individual's daily life. The diagnostic process for ADHD is complex, requiring a combination of clinical assessments and subjective evaluations. However, recent advances in artificial intelligence (AI) techniques have shown promise in predicting ADHD and providing an early diagnosis. In this study, we will explore the application of two AI techniques, K-Nearest Neighbors (KNN) and Adaptive Boosting (AdaBoost), in predicting ADHD using the Python programming language. The classification accuracies obtained w
... Show MorePraise be to God, prayer, and peace be upon the Messenger of Allah and his God and his companions. The field of the judiciary to prove or invalidate some cases in the field of proof of descent and attachment to the plaintiff or exile, and other legal and judicial issues, especially in this era where the spread of previously unknown evidence, such as DNA, which was discovered in 1953, and the genetic fingerprint discovered 1984, blood analysis and a Saliva, sweat, poetry, etc. in the field of forensic evidence, in forensic medicine or medical expertise, it can be used to identify the killer, or verify his identity, using all the evidence in the scene, such as a point of blood or sweat, and the like So, as well as to prove the lineage is u
... Show MorePharmaceutical companies assign a budget for activities and promotions that aim to change the prescription habits of the physicians to choose the most suitable medications for their patients, which will eventually grow their sales. The study's objectives were to explore physicians' and medical representatives' perspectives on the criteria of impactful professional PP and the factors influencing the interaction between physicians and medical representatives. Qualitative in-depth interviews with flexible probing techniques were carried out in 2023. A semi-structured, open-ended interview questionnaire was used to interview physicians and medical representatives (MRs) from different private clinics in several governorates in Iraq. Ten physicia
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the Objective of study is to measure the quality of medical service level, in the Iraq public hospitals ,presented by special words ,private hospitals, and compare between them, by knowing the level of recipients satisfaction of medical service for all dimensions of quality service, and then measuring satisfaction with the quality of medical service as a whole for both of them, which have been prepared in questionnaire form, included two main directions, first to determine the level of satisfaction when, recipients of medical service is not dimensions quality of service in accordance with the Scale Servqual by (Parasurman et .al 1988), consisting of five di
... Show MoreThe present study attempts to examine verbal/nonverbal impoliteness in the classroom interaction and outside it in one of the movies, namely, The Marva Collins. Impoliteness, which is significantly studied within pragmatics, is a negative attitude towards particular behaviors. It always presumes to have emotional concerns for at least one participant who has caused it. This study is an attempt to examine verbal/nonverbal impoliteness in The Marva Collins movie. The study aims to investigate the different types of impoliteness strategies used in the four selected scenes and find out whether the speaker’s status has anything to do with the types of impoliteness. Besides, the functions performed are also examined by following a qual
... Show MoreLow oil extraction and early high water production are caused in part by reservoir heterogeneity. Huge quantities of water production are prevalent issues that happen in older reservoirs. Polyacrylamide polymer gel systems have been frequently employed as plugging agents in heterogeneous reservoirs to regulate water output and increase sweep efficiency. Polyacrylamide polymer gel systems are classified into three classes depending on their composition and application conditions, which are in-situ monomer gel, in-situ polymer gel, and preformed particle gel (PPG).
This paper gives a comprehensive review of PPG’s status, preparation, and mechanisms. Many sorts of PPGs are categorized, for example, millimeter-sized preformed p
... Show MoreThere is no access to basic sanitation for half the world's population, leading to Socioeconomic issues, such as scarcity of drinking water and the spread of diseases. In this way, it is of vital importance to develop water management technologies relevant to the target population. In addition, in the separation form of water treatment, the compound often used as a coagulant in water treatment is aluminum sulfate, which provides good results for raw water turbidity and color removal. Studies show, however, that its deposition in the human body, even Alzheimer's disease, can cause serious harm to health and disease development. The study aims to improve the coagulation/flocculation stage related to the amount of flakes, i
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