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.
Significant advances in the automated glaucoma detection techniques have been made through the employment of the Machine Learning (ML) and Deep Learning (DL) methods, an overview of which will be provided in this paper. What sets the current literature review apart is its exclusive focus on the aforementioned techniques for glaucoma detection using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines for filtering the selected papers. To achieve this, an advanced search was conducted in the Scopus database, specifically looking for research papers published in 2023, with the keywords "glaucoma detection", "machine learning", and "deep learning". Among the multiple found papers, the ones focusing
... Show MoreDrilling well design optimization reduces total Authorization for Expenditures (AFE) by decreasing well constructing time and expense. Well design is not a constant pattern during the life cycle of the field. It should be optimized by continuous improvements for all aspects of redesigning the well depending on the actual field conditions and problems. The core objective of this study is to deliver a general review of the well design optimization processes and the available studies and applications to employ the well design optimization to solve problems encountered with well design so that cost effectiveness and perfect drilling well performance are achievable. Well design optimization processes include unconventional design(slimhole) co
... Show MoreThe aim of this study is to evaluate the anti fungal activity of a combination of essential oils against water molds. HPLC analysis was done to evaluate the quantity and quality of the active compounds in this combination which extracted from three herbs( Peppermint Menthapiperita ,Thyme Thymusvulgaris, Common sage Salvia officinalis L.) and the active compounds are Camphor,Menthol,,Thujone and Thymol with different concentrations. In this study (MIC) , (MFC) were measured and (LD50) determined after 48,96 h from fingerlings treatment of common carp in aquariums .The results of (MIC) were 0.025µl/ml for Aphanomyces sp. and 0.015µl/ml for both Achlya sp. and Fusariumsolani which showed significant differences(p<0.05) from Malachite gre
... Show MoreScience is linked to each other bonds assets, branches and even close to each other; to become a link of this type of patterns of scientific integration, and perhaps the most prominent science that saw the overlap and interdependence of science and jurisprudence and its origins, and this interdependence did not stop at the epistemological foundations of knowledge; To the branches, methods of extraction, and diligence to extend to the terminology; to find similar terms in both flags; to become those terms similar in the word and meaning and even the end, but we do not lack terms similar in pronunciation and differing in meaning; and this difference is imposed by the specificity of each science and what M E; however, approached many terms
... Show MoreA prey-predator interaction model has been suggested in which the population of a predator consists of a two-stage structure. Modified Holling's disk equation is used to describe the consumption of the prey so that it involves the additional source of food for the predator. The fear function is imposed on prey. It is supposed that the prey exhibits anti-predator behavior and may kill the adult predator due to their struggle against predation. The proposed model is investigated for existence, uniqueness, and boundedness. After determining all feasible equilibrium points, the local stability analyses are performed. In addition, global stability analyses for this model using the Lyapunov method are investigated. The chance of occurrence of loc
... Show MoreEffects of Ozonated Water on Micro Leakage between Enamel and Fissure Sealants Prepared by Different Etching Technique (An in vitro Study), Baraa M Jabar*, Muna S Khalaf
Tumor necrosis factor-alpha (TNF-α) antagonists’ therapy are expensive and has a non-responsive rate between 30% to 40% in rheumatoid arthritis patients. Genetic variation plays a vital role in the responsiveness to this type of therapy.The aim of this study is to investigate if the presence of genetic polymorphism in the TNF-α gene promoter region at locations -376 G/A (rs1800750), -806 C/T (rs4248158), and -1031 T/C (rs1799964) affects rheumatoid arthritis patient's tendency to be a non-responder to etanercept.
Eighty RA patients on etanercept (ETN) for at least six months were recruited from the Rheumatology Unit at Baghdad Teaching Hospital. Based on The European League Against Rheumatism response (EULAR) criteria, patient
... Show MoreAbstract
The current research aims to identify the role of family upbringing methods in shaping adolescent gender identity disorder, to identify the causes, components, and disorders of the gender identity of adolescents, and to develop practical visions and suggestions to reduce and stop gender identity disorder completely. Due to the sensitivity of the topic, a questionnaire of five open-ended questions was posted on Facebook to collect the needed data, where (20) respondents answered these questions. The researcher took these (20) respondents as the study sample. The results revealed that excessive emancipation within the family, failure to employ family protection laws, and failure to monitor and follow up on
... Show MoreObjective(s): To assess the behavior that impedes the eating of children with autism spectrum disorders in Baghdad city, and find out the relationships between the behaviors that impede eating of autistic children and their demographic characteristics.
Methodology: The study started from the period of 16th September 2019 to the 16th of March 2020. A non-probability (purposive) sample of 80 children with autism spectrum disorders was selected. The questionnaire was designed and composed of two parts: the first part includes the autistic children demographic data, the second part includes scales of behavior that impede eating followed by parents towards autistic child. The reliability of the questionnaire was determined through a pilot