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 fact of having Journalism being open to people from different orientations professions, working as journalists requiring protection just to spread corruption, is one of the biggest threats faced by journalism.
Journalists noticed the spread of unprincipled journalists with no journalistic ethics amongst them, they tried to protect their profession from these corrupt outsiders who might annihilate the mighty of journalism. The principles of the journalism profession known as journalistic ethics, are one the most important formulations of the law concluded by the journalists and those concerned by the the profession, they were then published in public in order to prove their professionalism, especially for those who don’t und
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Background: Colorectal cancer is the third most common cancer-related mortality worldwide, and its prevalence is increasing among many nations. Aim of the study: Investigate the predictive value of carbohydrate antigen 242 (CA242) in comparison to the CEA biomarker and to estimate the significance of CA242 as prognosis maker in colorectal cancer patients. Methods: a case-control study with a total of 150 individuals, 100 patients (59 males, 41 females) and 50 healthy controls (26 males, 24 females). using an enzyme-linked immunosorbent (ELISA) to determine the serum levels of CA242 and CEA. The study was carried out at the gastroenterology consultation clinic of the oncology teaching hospital between November 2020 and February
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Geotechnical engineering like any other engineering field has to develop and cope with new technologies. This article intends to investigate the spatial relationships between soil’s liquid limit (LL), plasticity index (PI) and Liquidity index (LI) for particular zones of Sulaymaniyah City. The main objective is to study the ability to produce digital soil maps for the study area and determine regions of high expansive soil. Inverse Distance Weighting (IDW) interpolation tool within the GIS (Geographic Information System) program was used to produce the maps. Data from 592 boreholes for LL and PI and 245 boreholes for LI were used for this study. Layers were allocated into three depth ranges (1 to 2, 2 to 4 and 4 to 6)
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Background: The highest concentrations of
blood glucose during the day are usually found
postprandialy. Postprandial hyperglycemia (PPH)
is likely to promote or aggravate fasting
hyperglycemia. Evidence in recent years suggests
that PPH may play an important role in functional
& structural disturbances in different body organs
particularly the cardiovascular system.
Objective: To evaluate the effect of (PPH) as a
risk factor for coronary Heart disease in Type 2
diabetic patients.
Methods: Sixty-three type2 diabetic patients
were included in this study. All have controlled
fasting blood glucose, with HbA1c correlation.
They were all followed for five months period
(from May to October 2008)
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Solar activity monitoring is important in our life because of its direct or indirect influence on our life, not only on ionospheric communications. To study solar activity, researchers need measuring and monitoring instruments, these instruments are mostly expensive and are not available in all universities. In this paper, a very low frequency radio receiver had been designed and implemented with components available in most markets to support the researchers, college students, and radio astronomy amateurs with a minimum input voltage less than 100µV, an output voltage less than 135 m V with no distortion and an overall gain of 34dB. A comparison had been done between two circuit structures using a workbench software program and experim
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Zernike Moments has been popularly used in many shape-based image retrieval studies due to its powerful shape representation. However its strength and weaknesses have not been clearly highlighted in the previous studies. Thus, its powerful shape representation could not be fully utilized. In this paper, a method to fully capture the shape representation properties of Zernike Moments is implemented and tested on a single object for binary and grey level images. The proposed method works by determining the boundary of the shape object and then resizing the object shape to the boundary of the image. Three case studies were made. Case 1 is the Zernike Moments implementation on the original shape object image. In Case 2, the centroid of the s
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A common problem facing many Application models is to extract and combine information from multiple, heterogeneous sources and to derive information of a new quality or abstraction level. New approaches for managing consistency, uncertainty or quality of Arabic data and enabling e-client analysis of distributed, heterogeneous sources are still required. This paper presents a new method by combining two algorithms (the partitioning and Grouping) that will be used to transform information in a real time heterogeneous Arabic database environment