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 surgeryKeywords: Non-surgical treatment of anal fissure, fissure in ano, sphicterotomy,botulinum toxin in anal fissures, glyceryl trinitrate. Chemical sphincteratomy, pharmacological sphincteratomy.
A case of angiolymphoid hyperplasia with eosinophilia (ALH) is reported in a 42-year-old woman who developed multiple nodules behind the ear. Angiolymphoid hyperplasia with eosinophilia usually occurs on the head and neck of young adults and is more common in women than in men. Characteristic histologic features of ALH present in this case included proliferation of thick-walled blood vessels lined by prominent endothelial cells, infiltration of the interstitium by chronic inflammatory cells (mainly eosinophils), and presence of lymphoid follicles with germinal centers. The patient referred for surgeon for complete excision. in this context , cases previously described in the literature, and the differential diagnosis of ALH are discussed
... Show MoreThe aim: to evaluate combined microscopy techniques for determining the morphological and optical properties of methadone hydrochloride (MDN) crystals. Materials and methods: MDN crystal formation was optimized using a closed container method and crystals were characterized using polarized light microscope (PLM), scanning electron microscopy (SEM) and confocal microscopy (CM). SEM and CM were used to determine MDN crystal thickness and study its relationship with crystal retardation colours using the Michel-Levy Birefringence approach. Results: Dimensions (mean±SD) of diamond shaped MDN crystals were confirmed using SEM and CM. Crystals were 46.4±15.2 Vs 32.0±8.3 µm long, 28.03±8.2 Vs 20.85±5.5 µm wide, and 6.62±
... Show MoreConflict, peace, and sports have a long history as practical realities, and their correlation has become an important subject of study in the last decades of the twentieth century. Sport has infiltrated peace and conflict studies as a tool for resolving conflict and building peace, but opinions have differed between those who say it is a positive tool and others who see it as negative. The Gulf Cup is one of the champions that have never been studied, and in-depth research about it has not been done. This tournament has affected the relations between the states involved. The politics cast its shadow on the Gulf Cup. The paper aims to shed light on how political events in the region have consistently affected the Gulf Cup and how politics in
... Show MoreAlumina thin films have significant applications in the areas of optoelectronics, optics, electrical insulators, sensors and tribology. The novel aspect of this work is that the homogeneous alumina thin films were prepared in several stages to generate a plasma jet. In this paper, aluminium nanoparticles suspended in vinyl alcohol were prepared using exploding wire plasma. TEM analysis was used to determine the size and shape of particles in aluminium and vinyl alcohol suspensions; the TEM images showed that the particle size is 17.2 nm. Aluminium/poly vinyl alcohol (Al/PVA) thin films were prepared using this suspension on quartz substrate by plasma jet technique at room temperature with an argon gas flow rate of 1 L/min. The Al/PV
... Show MoreThis study aims to encapsulate atenolol within floating alginate-ethylcellulose beads as an oral controlled-release delivery system using aqueous colloidal polymer dispersion (ACPD) method.To optimize drug entrapment efficiency and dissolution behavior of the prepared beads, different parameters of drug: polymer ratio, polymer mixture ratio, and gelling agent concentration were involved.The prepared beads were investigated with respect to their buoyancy, encapsulation efficiency, and dissolution behavior in the media: 0.1 N HCl (pH 1.2), acetate buffer (pH 4.6) and phosphate buffer (pH 6.8). The release kinetics and mechanism of the drug from the prepared beads was investigated.All prepared atenolol beads remained f
... Show More<p><span>This research deals with the feasibility of a mobile robot to navigate and discover its location at unknown environments, and then constructing maps of these navigated environments for future usage. In this work, we proposed a modified Extended Kalman Filter- Simultaneous Localization and Mapping (EKF-SLAM) technique which was implemented for different unknown environments containing a different number of landmarks. Then, the detectable landmarks will play an important role in controlling the overall navigation process and EKF-SLAM technique’s performance. MATLAB simulation results of the EKF-SLAM technique come with better performance as compared with an odometry approach performance in terms of measuring the
... Show MoreBackground: Prevention against nosocomial infection is an important issue of health care field and considered a challenge of patients’ since it reflects its effect on their quality of life. This due to that it will lead in most cases to prolonged hospitalization and also more cost.Objective: To determine the prevalence of different types of nosocomial infection and to demonstrate the association of different risk factors (hospital environment, workers, visitors) with nosocomial infection.Patients: this study was carried out in eleven months at Ba’quba general Hospital; Iraq. A total of 81 clinical specimens (urine, pus from abscess , burn swab, nasal swab, ear swab and wound swab) taken from surgical patients,102 specimens from
... Show MoreBackground: Congenital club foot is a complex deformity of foot .It is a collection of different abnormalities, with different etiologies. Consequently, Severity varies with difficulties in evaluating treatment strategies with outcome results. The treatment of congenital club foot remains controversial. Usually, the orthopedist's goal is to obtain anatomically and functionally normal feet in all patients. Objective: To asses short term follow up result of conservatively treated club feet in relation to the age of initial casting by Ponseti technique. Methods :A cross sectional observational study with some comparative content done in Al-kindy
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