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.
Retained soft tissue foreign bodies following injuries are frequently seen in the Emergency and Plastic Surgery practice. The patients with such presentations require a watchful and detailed clinical as- sessment to overcome the anticipant possibility of missing them. However, the diagnosis based on the clinical evaluation is usually challenging and needs to be supported by imaging modalities that are suboptimal and may fail in identifying some types of foreign bodies. Owing to that, serious complications such as chronic pain, infection, and delayed wound healing can be faced that necessitate a prompt intervention to halt those detrimental consequences. The classical method of removal is a surgical exploration which is not free of risks.
... Show MoreNumerous academic and critical studies concerned with the language of poetry, with the differences and diversity in these studies and the critical methods. , the study tries to study this modern approach in the language Iraqi and Arabic poetry according to analyzing and following the functional dimension of the language, regardless of its poetic value which should be on them, as each poetic experience has its own language, thestudy came to investigate the variety of poetry samples, poets from different and far generations. - in an attempt to give an image Career dimension of language, the center of intellectual transformations that have affected the experience of Arabic poetry generally, and the level of language to be exact, as a tool f
... Show MoreThree types of zeolite A were prepared from Iraqi kaoline which are 3A, 4A and 5A by ion exchange method .They were characterized by XRD and atomic absorption techniques .They were used as adsorbents to examine their applicability for H2S adsorption .The adsorption process was performed in a static form and constant volume system which constructed from stainless steel .The effect of zeolite type and temperature on the adsorption properties of H2S at -5 , 25 and 55 oC was studied .The zeolite type 5A has the highest adsorption value (79.384 µmol/g ) and the three types may be arranged in a sequence toward H2S adsorption as 5 A> 4A>3A .The amount of H2S adsorbed increased as temperature decreased from 55 to -5 for all samples. Langmuir , Fre
... Show MoreIn this paper, a new analytical method is introduced to find the general solution of linear partial differential equations. In this method, each Laplace transform (LT) and Sumudu transform (ST) is used independently along with canonical coordinates. The strength of this method is that it is easy to implement and does not require initial conditions.
The need for quick airborne transportation is critical, especially in emergencies. Drones with suspended payloads might be used to accomplish quick airborne transportation. Due to the environment or the drone's motion, the slung load may oscillate and lead the drone to fall. The altitude and attitude controls are the backbones of the drone's stability, and they must be adequately designed. Because of their symmetrical and simple structure, quadrotor helicopters are one of the most popular drone classes. In this work, a genetic algorithm with two weighted terms fitness function is used to adjust a Proportional-Integral-Derivative (PID) controller to compensate for the altitude and attitude controllers in a quadrotor drone
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