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.
Abstract
The vegetative filter strips (VFS) are a useful tool used for reducing the movement of sediment and pesticide in therivers. The filter strip’s soil can help in reducing the runoff volume by infiltration. However, the characteristics of VFS (i.e., length) are not recently identified depending on the estimation of VFS modeling performance. The aim of this research is to study these characteristics and determine acorrelation between filter strip length and percent reduction (trapping efficiency) for sediment, water, and pesticide. Two proposed pesticides(one has organic carbon sorption coefficient, Koc, of 147 L/kg which is more moveable than XXXX, and another one
... Show MoreBackground. In cases of spontaneous subarachnoid haemorrhage (SAH) with multiple intracranial aneurysms (MIAs) detected on angiography, some radiological clues assist in determining the site of a ruptured aneurysm which is bleeding is quite beneficial for the selection of the best treatment strategy. Case description. We report a case of a 60 years old patient who presented with spontaneous SAH, sellar hematoma, and three different aneurysms detected in angiography. Although the right Posterior communicating artery (PcomA) aneurysms showed Murphy’s teat on angiography intraoperatively, we discovered that the right superior hypophyseal aneurysm (SHA) was the source of the index bleeding. Both aneurysms were clipped successfully. Co
... Show MoreThe research aims to conduct a comparative study between the events (800) m and (1500) m track in the types of muscular strength and to identify the differences between them among Iraqi sports club players. The sample represented the players participating in the Iraqi Athletics Championship for the period between (02/11/2023) and (04 /11/2023), and their number was (16) players (8) for each event, as the selection was made intentionally. The researchers used the descriptive approach to achieve the goal of the research and used the statistical package (SPSS) to process the data statistically. According to the results collected, it was found that there was superiority among the intermediate track players (800) m in explosive power and the s
... Show MoreCysteine-cysteine chemokine ligand 5 (CCL5) is known to play an important role with immunoregulatory and inflammatory activities in the formation of granuloma during infection with Mycobacterium tuberculosis. About 90 subjects, involving 50 patients with pulmonary TB and 40 apparently healthy individuals (as a control group) were collected from primary health care center\AL-Sadur city sector/ Baghdad City/ Iraq, and at specialized chest and respiratory diseases center in Wassit City /Iraq during the period from January 2019 to May 2019. The study was carried out to investigate serum level of CCL-5 of both patients and control by using enzyme linked immunosorbent assay (ELISA), and to determine the association between CCL5 genotypes with pul
... Show MoreThe aim of this paper is to present a new methodology to find the private key of RSA. A new initial value which is generated from a new equation is selected to speed up the process. In fact, after this value is found, brute force attack is chosen to discover the private key. In addition, for a proposed equation, the multiplier of Euler totient function to find both of the public key and the private key is assigned as 1. Then, it implies that an equation that estimates a new initial value is suitable for the small multiplier. The experimental results show that if all prime factors of the modulus are assigned larger than 3 and the multiplier is 1, the distance between an initial value and the private key
... Show MoreThis research describes a new model inspired by Mobilenetv2 that was trained on a very diverse dataset. The goal is to enable fire detection in open areas to replace physical sensor-based fire detectors and reduce false alarms of fires, to achieve the lowest losses in open areas via deep learning. A diverse fire dataset was created that combines images and videos from several sources. In addition, another self-made data set was taken from the farms of the holy shrine of Al-Hussainiya in the city of Karbala. After that, the model was trained with the collected dataset. The test accuracy of the fire dataset that was trained with the new model reached 98.87%.
This paper deals with modelling and control of Euler-Bernoulli smart beam interacting with a fluid medium. Several distributed piezo-patches (actuators and/or sensors) are bonded on the surface of the target beam. To model the vibrating beam properly, the effect of the piezo-patches and the hydrodynamic loads should be taken into account carefully. The partial differential equation PDE for the target oscillating beam is derived considering the piezo-actuators as input controls. Fluid forces are decomposed into two components: 1) hydrodynamic forces due to the beam oscillations, and 2) external (disturbance) hydrodynamic loads independent of beam motion. Then the PDE is discretized usi
The article characterizes metaphors and comparisons as a means of rethinking the phenomena of the surrounding world; two directions are named within which metaphors and comparisons are studied: 1) the linguo-classification direction combines several classifications of metaphors and comparisons, which are basically focused on comparing two denotations through the meanings of word forms that are part of the trope; 2) the theoretical and conceptual direction is associated with the concept of conceptual displacement and is the basis of the theoretical and methodological study of metaphor and comparison, i.e. the modern theory of metaphor is being formed; The main attention is focused on the comparative concept of Aristotle, which postul
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