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 present work includes a design and characteristics study of a controlling the wavelength of high power diode laser by thermoelectric cooler [TEC] . The work includes the operation of the [TEC] to control the temperature of the diode laser between ( 0- +30) °C by changing the resistance of thermistor. We can control a limited temperature of a diode laser by changing the phase cooling between hot and cold faces of the diode, this process can be attempted by comparator type [LM –311] .The theoretical results give a model for controlling the temperature with, the suitable wavelength.
The effect of linear thermal stratification in stable stationary ambient fluid on free convective flow of a viscous incompressible fluid along a plane wall is numerically investigated in the present work. The governing equations of continuity, momentum and energy are solved numerically using finite difference method with Alternating Direct implicit Scheme. The velocity, temperature distributions
and the Nusselt number are discussed numerically for various values of physical parameters and presented through graphs. ANSYS program also used to solve the problem. The results show that the effect of stratification parameter is marginalized with the increase in Prandtl number, and the increase in Grashof number does not practically vary the
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Background: Knowledge about the prevalence and distribution of pathologies in a particular location is important when a differential diagnosis is being formulated. The aim of this study was to describe the prevalence and the clinicopathological features of odontogenic cysts and tumors affecting the maxilla and to discuss the unusual presentation of those lesions within maxillary sinus.
Materials and Methods: A multicenter retrospective analysis was performed on pathology archives of patients who were diagnosed with maxillary odontogenic cysts and tumors from 2010 to 2020. Data were collected with respect to age, gender and location.
Result: A total of 384 cases was identified, 320 (83.3%) cases were diagnosed as odontogenic
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The determination of aerodynamic coefficients by shell designers is a critical step in the development of any projectile design. Of particular interest is the determination of the aerodynamic coefficients at transonic speeds. It is in this speed regime that the critical aerodynamic behavior occurs and a rapid change in the aerodynamic coefficients is observed. Two-dimensional, transonic, flow field computations over projectiles have been made using Euler equations which were used for solution with no special treatment required. In this work a solution algorithm is based on finite difference MacCormack’s technique for solving mixed subsonic-supersonic flow problem. Details of the asymmetrically located shock waves on the projectiles hav
... Show MoreProfessional learning societies (PLS) are a systematic method for improving teaching and learning performance through designing and building professional learning societies. This leads to overcoming a culture of isolation and fragmenting the work of educational supervisors. Many studies show that constructing and developing strong professional learning societies - focused on improving education, curriculum and evaluation will lead to increased cooperation and participation of educational supervisors and teachers, as well as increases the application of effective educational practices in the classroom.
The roles of the educational supervisor to ensure the best and optimal implementation and activation of professional learning soci
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Background: Patients requiring renal biopsies have various glomerular diseases according to their demographic characteristics.
Objective: To study types of glomerular disease among adult Iraqi patients in a single center in Baghdad/Iraq
Material and Methods: A total of 120 native kidney biopsies were studied. All biopsies were adequate and were processed for Light Microscopy.
The age range of the study patients was 17-67 years, with a mean of 38.5 years. The mean follow up period was 28 weeks (4-52 weeks)
Indication for biopsy included: Nephrotic syndrome (N=72; 60%), Asymptomatic proteinuria (N=21; 17.5%), acute nephritic presentation (N=17; 14.16%), asymptomatic haematuria (N=10; 8.33%).
Results: Primary glomerulonephrit
The growing use of tele
This paper presents a new secret diffusion scheme called Round Key Permutation (RKP) based on the nonlinear, dynamic and pseudorandom permutation for encrypting images by block, since images are considered particular data because of their size and their information, which are two-dimensional nature and characterized by high redundancy and strong correlation. Firstly, the permutation table is calculated according to the master key and sub-keys. Secondly, scrambling pixels for each block to be encrypted will be done according the permutation table. Thereafter the AES encryption algorithm is used in the proposed cryptosystem by replacing the linear permutation of ShiftRows step with the nonlinear and secret pe
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