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.
Introduction Periodontal diseases are ranked among the most common health problems affecting mankind. These conditions are initiated by bacterial biofilm, which is further modulated by several risk factors. Objectives To investigate the association of different risk factors with periodontal...
A simple straightforward mathematical method has been developed to cluster grid nodes on a boundary segment of an arbitrary geometry that can be fitted by a relevant polynomial. The method of solution is accomplished in two steps. At the first step, the length of the boundary segment is evaluated by using the mean value theorem, then grids are clustered as desired, using relevant linear clustering functions. At the second step, as the coordinates cell nodes have been computed and the incremental distance between each two nodes has been evaluated, the original coordinate of each node is then computed utilizing the same fitted polynomial with the mean value theorem but reversibly.
The method is utilized to predict
... Show MoreWireless Multimedia Sensor Networks (WMSNs) are a type of sensor network that contains sensor nodes equipped with cameras, microphones; therefore the WMSNS are able to produce multimedia data such as video and audio streams, still images, and scalar data from the surrounding environment. Most multimedia applications typically produce huge volumes of data, this leads to congestion. To address this challenge, This paper proposes Modify Spike Neural Network control for Traffic Load Parameter with Exponential Weight of Priority Based Rate Control algorithm (MSNTLP with EWBPRC). The Modify Spike Neural Network controller (MSNC) can calculate the appropriate traffi
... Show MoreOne of the most popular and legally recognized behavioral biometrics is the individual's signature, which is used for verification and identification in many different industries, including business, law, and finance. The purpose of the signature verification method is to distinguish genuine from forged signatures, a task complicated by cultural and personal variances. Analysis, comparison, and evaluation of handwriting features are performed in forensic handwriting analysis to establish whether or not the writing was produced by a known writer. In contrast to other languages, Arabic makes use of diacritics, ligatures, and overlaps that are unique to it. Due to the absence of dynamic information in the writing of Arabic signatures,
... Show MoreThe Love Creek Nature Center, one of the three nature centers located within the boundaries of Berrien County, is owned and operated by the county for public enjoyment and instruction of nature. The 44.5 ha study area, located seven km east of Berrien Springs, and two km southwest of Berrien Center, on Huckleberry Road, in T6S, R17W, sections 16, 17 (Lat. 41° 56' N; Long. 86° 18' W) is made up of deciduous woods and abandoned fields at various stages of succession. It is bounded on the east by the Berrien County Dog Pound and Huckleberry Road, to the north by cultivated Berrien County land and the Berrien General Hospital, to the west by the recently closed Berrien - Oronoko Township Landfill Dump; and to the south b
... Show MoreWe demonstrate a behavior of laser pulse grows through fiber laser inside and output cavity with a soliton fiber laser based on the multi-wall carbon nanotube saturable absorber (SA), we investigate the effects of a saturable absorber parameter on the mode-locking of a realistic Erbium fiber ring laser. Generalized nonlinear Schrodinger equation including the nonlinear effects as gain dispersion, second anomalous group velocity dispersion (GVD), self phase modulation (SPM), and two photon absorption used to describe pulse evolution. An analytical method has been used to understand and to quantify the role of the SA parameter on the propagation dynamics of pulse laser. We compute the chirp, power, width and phase of the soliton for range
... Show MoreBackground: Human semen contains high concentrations of fructose, zinc (Zn) and copper (Cu) in bound and ionic forms for Zn and Cu. The presence of abnormal levels of fructose and those trace elements may affect spermatogenesis with regard to production, maturation, motility and fertilizing capacity of the spermatozoa.Objective: To evaluate the levels of fructose, Zn and Cu in seminal plasma in different groups of male infertility and to correlate their concentrations with various sperm parameters.Methods: The concentrations of fructose, Zn and Cu were measured in 114 semen samples from normozoospermic, oligozoospermic, astheno-zoospermic, and azoospermic men using the electrothermal-atomic absorption spectrometry for Zn and Cu determinatio
... Show MoreSignature verification involves vague situations in which a signature could resemble many reference samples or might differ because of handwriting variances. By presenting the features and similarity score of signatures from the matching algorithm as fuzzy sets and capturing the degrees of membership, non-membership, and indeterminacy, a neutrosophic engine can significantly contribute to signature verification by addressing the inherent uncertainties and ambiguities present in signatures. But type-1 neutrosophic logic gives these membership functions fixed values, which could not adequately capture the various degrees of uncertainty in the characteristics of signatures. Type-1 neutrosophic representation is also unable to adjust to various
... Show MoreThe research discusses the need to find the innovative structures and methodologies for developing Human Capital (HC) in Iraqi Universities. One of the most important of these structures is Communities of Practice (CoPs) which contributes to develop HC by using learning, teaching and training through the conversion speed of knowledge and creativity into practice. This research has been used the comparative approach through employing the methodology of Data Envelopment Analysis (DEA) by using (Excel 2010 - Solver) as a field evidence to prove the role of CoPs in developing HC. In light of the given information, a researcher adopted on an archived preliminary data about (23) colleges at Mosul University as a deliberate sample for t
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