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 goal of the research is to theoretically establish the variable of brilliant leadership and explain the importance of this variable and the philosophical orientation of researchers in taking it as an original variable in their research as an independent variable. The descriptive approach and theoretical framing of brilliant leadership were followed. We relied on secondary data represented by books, dissertations, dissertations, scientific research, and the information network (the Internet) as a tool for collecting data. The scientific value was represented by the importance of consolidating brilliant leadership and reviewing the most important things that were confirmed by the research and studies that dealt with this research.
... Show MoreDeep learning techniques are applied in many different industries for a variety of purposes. Deep learning-based item detection from aerial or terrestrial photographs has become a significant research area in recent years. The goal of object detection in computer vision is to anticipate the presence of one or more objects, along with their classes and bounding boxes. The YOLO (You Only Look Once) modern object detector can detect things in real-time with accuracy and speed. A neural network from the YOLO family of computer vision models makes one-time predictions about the locations of bounding rectangles and classification probabilities for an image. In layman's terms, it is a technique for instantly identifying and recognizing
... Show MoreBackground: Inflammation of the brain parenchyma brought on by a virus is known as viral encephalitis. It coexists frequently with viral meningitis and is the most prevalent kind of encephalitis. Objectives: To throw light on viral encephalitis, its types, epidemiology, symptoms and complications. Results: Although it can affect people of all ages, viral infections are the most prevalent cause of viral encephalitis, which is typically seen in young children and old people. Arboviruses, rhabdoviruses, enteroviruses, herpesviruses, retroviruses, orthomyxoviruses, orthopneumoviruses, and coronaviruses are just a few of the viruses that have been known to cause encephalitis. Conclusion: As new viruses emerge, diagnostic techniques advan
... Show MoreDeep learning techniques are used across a wide range of fields for several applications. In recent years, deep learning-based object detection from aerial or terrestrial photos has gained popularity as a study topic. The goal of object detection in computer vision is to anticipate the presence of one or more objects, along with their classes and bounding boxes. The YOLO (You Only Look Once) modern object detector can detect things in real-time with accuracy and speed. A neural network from the YOLO family of computer vision models makes one-time predictions about the locations of bounding rectangles andclassification probabilities for an image. In layman's terms, it is a technique for instantly identifying and rec
... Show MoreThe accounting system of government is considered an important tool to follow up the financial transactions that reflect the activities of governmental units and by which the useful information for estimating governmental annual revenues and expenditures are provided through the state public budget because it is an information system that provides detailed past performance, as well as measures the efficiency of the governmental agencies performance in implementing the budget, and the of success governmental units is measured through the type of services and programs offered, their size and the possibility of achieving the objectives assigned to them. The medical evacuation program is one of the medical and curative health services provid
... Show MoreBackground: A carefully planned clinical medical education is critical for the provision of supportive clinical educational environment. The latter will ensure effective teaching, active learning and good attitudes and performance at the bedside. The aim of this study was to evaluate clinical learning environment at AL-Diwaniyah Teaching Hospital. Materials and Methods: A descripitive cross-sectional study involved resident doctors from Internal Medicine and Surgery departments who had six months or more residency training in the respective departments. Data were collected using the Postgraduate Hospital Educational Environment Measure. Data where analyzed using the Statistical Package for Social Sciences version 21.0 and presented us
... Show MoreThe growth of developments in machine learning, the image processing methods along with availability of the medical imaging data are taking a big increase in the utilization of machine learning strategies in the medical area. The utilization of neural networks, mainly, in recent days, the convolutional neural networks (CNN), have powerful descriptors for computer added diagnosis systems. Even so, there are several issues when work with medical images in which many of medical images possess a low-quality noise-to-signal (NSR) ratio compared to scenes obtained with a digital camera, that generally qualified a confusingly low spatial resolution and tends to make the contrast between different tissues of body are very low and it difficult to co
... Show MoreOBJECTIVE: To evaluate the patient satisfaction to hospital services and identify factors that influences this satisfaction.