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 problem of housing in Iraq is a long-rooted and rooted problem, and it needs a great effort to find out its causes and thus give essential points that contribute to alleviating and addressing it, and it is worth noting that research into the housing problem and the housing sector in Iraq is not done in isolation from other sectors and studies. As well as the economic policies pursued and the social and political conditions. It is known that the Iraqi economy is a unilateral (rentier) economy, that is, it depends almost entirely on exporting oil and obtaining revenues, and that the economic decision and economic policies followed in Iraq are greatly affected by several factors, including the economic, social and political fact
... Show MoreInformation hiding strategies have recently gained popularity in a variety of fields. Digital audio, video, and images are increasingly being labelled with distinct but undetectable marks that may contain a hidden copyright notice or serial number, or even directly help to prevent unauthorized duplication. This approach is extended to medical images by hiding secret information in them using the structure of a different file format. The hidden information may be related to the patient. In this paper, a method for hiding secret information in DICOM images is proposed based on Discrete Wavelet Transform (DWT). Firstly. segmented all slices of a 3D-image into a specific block size and collecting the host image depend on a generated key
... Show MoreThis paper exclusively deals with medical encounters. . Structurally and thematically, it manifests itself in five parts. The First part deals with medical encounters as well as essential speech activities which cover (a) frames (certain types of talk) (b) the patient’s account and the patient’s story or more precisely the patient telling his story and (c) the act of questioning the patient. The Second part revolves round genre and register. The former, in most cases, suggests that the format of medical encounters is conversational. With register; we have a converse reality that restrictively tries to narrow things and give them a certain flavor. The Third part realizes the technicalities of medical encounters (a) the setting of an inte
... Show MoreThe 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
... Show MoreWives 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 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
... Show MoreThis study was (the reality of beekeeping in Iraq and ways of developing them) as a research project in the branch of production is important branches of the productivity of the agricultural sector in Iraq, and the importance of this section, productive (beekeeping) for the agricultural sector in his contribution to increase the vegetable production and improve the quality and the various Classes of types, through its active role in the pollination of plants and indirectly (when the bees to move between plants to collect nectar and pollen grains), which contributes to reduce the losses in plant production and raise the rate of productivity per donum of various agricultural crops.
On the other hand play a
... Show MoreThis research investigates solid waste management in Al-Kut City. It included the collection of medical and general solid waste generated in five hospitals different in their specialization and capacity through one week, starting from 03/02/2012. Samples were collected and analyzed periodically to find their generation rate, composition, and physical properties. Analysis results indicated that generation rate ranged between (1102 – 212) kg / bed / day, moisture content and density were (19.0 % - 197 kg/ m3) respectively for medical waste and (41%-255 kg/ m3) respectively for general waste. Theoretically, medical solid waste generated in Al-Kut City (like any other city), affected by capacity, number of patients in a day, and hosp
... Show MoreThe main challenge is to protect the environment from future deterioration due to pollution and the lack of natural resources. Therefore, one of the most important things to pay attention to and get rid of its negative impact is solid waste. Solid waste is a double-edged sword according to the way it is dealt with, as neglecting it causes a serious environmental risk from water, air and soil pollution, while dealing with it in the right way makes it an important resource in preserving the environment. Accordingly, the proper management of solid waste and its reuse or recycling is the most important factor. Therefore, attention has been drawn to the use of solid waste in different ways, and the most common way is to use it as an alternative
... Show MoreThe recent advancements in security approaches have significantly increased the ability to identify and mitigate any type of threat or attack in any network infrastructure, such as a software-defined network (SDN), and protect the internet security architecture against a variety of threats or attacks. Machine learning (ML) and deep learning (DL) are among the most popular techniques for preventing distributed denial-of-service (DDoS) attacks on any kind of network. The objective of this systematic review is to identify, evaluate, and discuss new efforts on ML/DL-based DDoS attack detection strategies in SDN networks. To reach our objective, we conducted a systematic review in which we looked for publications that used ML/DL approach
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