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.
Zinc Oxide is an indispensable substance in the field of dental treatment. It is used daily and intensively in all governmental and private dental clinics, leading to the disposal of very high concentrations of zinc with waste and eventually in landfill sites as a final destination for solid waste removal. This indicates the urgent need to investigate its behavior upon disposal due to the surrounding conditions. Approximately 4195 g of mixed dental waste samples were collected from (17) healthcare centers in Baghdad Al-Karkh. The leaching behavior of ZnO powder was investigated through batch reactors using makeup dental solid waste samples. The ZnO leaching was tested with 3 conditions; acidic, alkaline, and Ionic Streng
... Show MoreComputer-aided diagnosis (CAD) has proved to be an effective and accurate method for diagnostic prediction over the years. This article focuses on the development of an automated CAD system with the intent to perform diagnosis as accurately as possible. Deep learning methods have been able to produce impressive results on medical image datasets. This study employs deep learning methods in conjunction with meta-heuristic algorithms and supervised machine-learning algorithms to perform an accurate diagnosis. Pre-trained convolutional neural networks (CNNs) or auto-encoder are used for feature extraction, whereas feature selection is performed using an ant colony optimization (ACO) algorithm. Ant colony optimization helps to search for the bes
... Show MoreAlthough the number of stomach tumor patients reduced obviously during last decades in western countries, but this illness is still one of the main causes of death in developing countries. The aim of this research is to detect the area of a tumor in a stomach images based on fuzzy clustering. The proposed methodology consists of three stages. The stomach images are divided into four quarters and then features elicited from each quarter in the first stage by utilizing seven moments invariant. Fuzzy C-Mean clustering (FCM) was employed in the second stage for each quarter to collect the features of each quarter into clusters. Manhattan distance was calculated in the third stage among all clusters' centers in all quarters to disclosure of t
... Show MoreThe value of time out as a time not count of official time form the game like four periods and extra time also it considered a great interest if used well thru the game , the importance of this problem is not using well the time out and when the coach ask for time out and how to invest this time legally to make good results also there is no observing system as the researcher see gives the reality image that the coach is successful lead the game when he takes time out . The goals of research that knowing on numbers of time out for excellent teams in Iraq (first &second) stages and putting special inventory reverse reality of asking time out (positive &negative) on playing basketball , the hypothesis of research that tell the time out effect
... Show MoreKey words:Jasminumsambac, Volatile oil, Antioxidant.
This paper analysed the effect of electronic internal auditing (EIA) based on the Control Objectives for Information and Related Technologies (COBIT) framework. Organisations must implement an up-to-date accounting information system (AIS) capable of meeting their auditing requirements. Electronic audit risk (compliance assessment, control assurance, and risk assessment) is a development by Weidenmier and Ramamoorti (2006) to improve AIS. In order to fulfil the study’s objectives, a questionnaire was prepared and distributed to a sample comprising 120 employees. The employees were financial managers, internal auditors, and workers involved in the company’s information security departments in the General Company for Electricity D
... Show MoreThe design was distinguished in Late Twenty-First Century With new and new methods Through which the ability to adapt all technical media in the formation of two-dimensional and three-dimensional figures and shapes was achieved .
Which led to the emergence of endless sets of design ideas characterized by the heterogeneity of design forms and design solutions that preceded it. The designer could not access these creations in various architectural and artistic fields only through computer programs, especially those related to the activation of mathematical logic and what is known as algorithms in the formation and construction of the form, which led to the emergence of the "parametric direction" and the problem of research is summarized