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 internet of medical things (IoMT), which is expected the lead to the biggest technology in worldwide distribution. Using 5th generation (5G) transmission, market possibilities and hazards related to IoMT are improved and detected. This framework describes a strategy for proactively addressing worries and offering a forum to promote development, alter attitudes and maintain people's confidence in the broader healthcare system without compromising security. It is combined with a data offloading system to speed up the transmission of medical data and improved the quality of service (QoS). As a result of this development, we suggested the enriched energy efficient fuzzy (EEEF) data offloading technique to enhance the delivery of dat
... Show MoreThe internet of medical things (IoMT), which is expected the lead to the biggest technology in worldwide distribution. Using 5th generation (5G) transmission, market possibilities and hazards related to IoMT are improved and detected. This framework describes a strategy for proactively addressing worries and offering a forum to promote development, alter attitudes and maintain people's confidence in the broader healthcare system without compromising security. It is combined with a data offloading system to speed up the transmission of medical data and improved the quality of service (QoS). As a result of this development, we suggested the enriched energy efficient fuzzy (EEEF) data offloading technique to enhance the delivery of dat
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Cyber security is a term utilized for describing a collection of technologies, procedures, and practices that try protecting an online environment of a user or an organization. For medical images among most important and delicate data kinds in computer systems, the medical reasons require that all patient data, including images, be encrypted before being transferred over computer networks by healthcare companies. This paper presents a new direction of the encryption method research by encrypting the image based on the domain of the feature extracted to generate a key for the encryption process. The encryption process is started by applying edges detection. After dividing the bits of the edge image into (3×3) windows, the diffusions
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Wives generally and working wives especially may encounter in some
families forms of physical or psychological violence through all the
levels or whether it was a psychological intimidation or cursing and
insolence and detracting her human . value and the husband marries
another woman or uses physical abuse against her and beating and
sexual abuse of the wife are also included in this from . it is noticed that
the violent attitude of the husband may take one from or it may change
and alter with time for it might lead to the increase of the possibility of
violence to occur in different ways
The importance of this study comes out from the step that on which in
folds the problem of the use of the husband of vio
The study aims to reach a common point that achieves a balance between two interests, which are generally in conflict with the public interest and the interest of the individual owner of private property, by extrapolating the provisions of the constitutional judiciary that include the protection of private property, and this protection extends to every right of financial value and is not limited to a specific type, but It included everything that can be estimated with money, as ownership is no longer an advantage for the owner, but rather has become a right for him and a social function. The tax is imposed on what is derived from it, but if there is a need to prejudice it, the conditions, limits and restrictions expressly stipulated in the
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This study aimed to assess the possible association of oxytocin (OXT) gene with reproductive traits in two groups of Awassi ewes that differ in their reproductive potentials. Sheep were genotyped using PCR—single-stranded conformation polymorphism approach. Three genotypes were detected in exon 2, CC, CA, and AA, and a novel SNP was identified with a missense effect on oxytocin (c.188C > A → p.Arg55Leu). A significant (p < 0.01) association of p.Arg55Leu with the twinning rate was found as ewes with AA and CA genotypes exhibited, respectively a lower twinning ratio than those with the wild-type CC genotype. The deleterious impact of p.Arg55Leu was demonstrated by all in silico tools that were utilized to assess the effect of this varian
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The design studies, especially in their contemporary stages, have not been isolated from the subjects that underpin advanced ideas in the field of technical treatments that enrich and improve the social life of users through those technological innovations that have enhanced and changed life styles, Especially in the field of general institutional techniques, including cinemas, as the ideal places for people and visitors to this space, which can contribute to the promotion of cultural, social and technical aspects within this millennium. DONC as reflected on the positive communication and communication between the intellectual and cognitive develop individuals, including cultural and technical side of the individual. The first chapter co
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Huge yearly investments were made by organizations for the development and maintenance. However, it has been reported that most of the IT projects fails as it is delayed, over budget and discontinued quality. A systematic literature review (SLR) was conducted to identify the critical success factors (CSFs) for the IT projects. Nine (9) CSFs was identified from the SLR. An online survey was conducted among 103 respondents from developers and IT managers. The data was analyzed using the Statistical Package for Social Science (SPSS 22). The findings showed that the highest CSFs of IT projects is commitment and motivation. Project monitoring was found the lowest score ranked by respondents.
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Phenol condensed with β-keto esters via Pechmann condensation to form derivatives of Coumarin in various reaction conditions by two ways. Present paper is comparative study of synthesis Coumarin with the yield of product , reaction time and reaction conditions.