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.
Abstract The strategic performance of the United States depends on dealing with the Middle East countries and its variants on several bases and motives that enabled them to achieve American hegemony and invest its interests at the expense of the region countries. Within this performance, the administration of the United State President Donald Trump presented the Strategic Document on December 18, 2017, which focused on the principle of "America First", to determine the direction of future US strategic performance in the formulation of means of cooperation and intersections or hostility in addition to interests and threats.The future vision of the Arab region and the Middle East as a whole, this strategy is based on the fact that
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A new laboratory study conducted on stepped spillways in order to investigate their efficiency of dissipating flow energy. All previous study on stepped spillway indicated that the flow energy dissipation decreased as increasing in discharge. Increasing in the step numbers and the spillway slope led to energy dissipation decrease. In this study, an experimental attempt to increase energy dissipation at variable discharges was performed on stepped spillway and that leads to decreasing the cost of initiating the stilling basin or may be ignoring it. Five spillways were constructed from concrete and tested to investigate and compare among them. Three were roughed by gravel with different size for each one, one of them was s
... Show MoreBackground: Multiple sclerosis is a chronic heterogeneous demyelinating axonal and inflammatory disease involving the Central Nervous System [CNS] white matter with a possibility of gray matter involvement in which the insulating covers of nerve cells in the brain and spinal cord are damaged. This damage disrupts the ability of parts of the nervous system to communicate, resulting in a wide range of signs and symptoms. Cerebral venous insufficiency theory was raised as a possible etiology for the disease at 2008 by Zamboni an Italian cardiothoracic surgeon. This theory was defeated by Multiple Sclerosis[ MS] researchers and scientists who thought that the disease is an autoimmune rather than vascular.
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In the pandemic era of COVID19, software engineering and artificial intelligence tools played a major role in monitoring, managing, and predicting the spread of the virus. According to reports released by the World Health Organization, all attempts to prevent any form of infection are highly recommended among people. One side of avoiding infection is requiring people to wear face masks. The problem is that some people do not incline to wear a face mask, and guiding them manually by police is not easy especially in a large or public area to avoid this infection. The purpose of this paper is to construct a software tool called Face Mask Detection (FMD) to detect any face that does not wear a mask in a specific
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Background: Skull secondary tumors are malignant bone tumors which are increasing in incidence.Objective: The objectives of this study were to present clinical features , asses the outcome of patients with secondary skull tumors ,characterize the MRI features, locations, and extent of secondary skull tumors to determine the frequency of the symptomatic disease.Type of the study: This is a prospective study.Methods: This is a prospective study from February 2000 to February 2008. The patients were selected from five neurosurgical centers and one oncology hospital in Baghdad/Iraq. The inclusion criteria were MRI study of the head(either as an initial radiological study or following head CT scan when secondary brain tumor is suspected , vis
... Show MoreBiological drugs have an active substance that is made by a living organism or derived from a living organism. They are one of the important therapy options used in a wide range of diseases especially life-threatening diseases. Biological therapy opens new opportunities for treating different diseases for which drug therapy is minimal, but they have considerable differences in the safety consequences in comparison with non-biological drugs. The aim of the current study was to assess the post-marketing safety profile of biological drugs used in Iraqi hospitals by the analysis of the reported adverse drug reactions regarding their severity, seriousness, preventability, expectedness, and outcome. It is a retrospective study of the individu
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In this research project, a tip-tilting angle of a photovoltaic solar cell was developed to increase generated electrical power output. An active, accurate, and simple dual-axis tracking system was designed by using an Arduino Uno microprocessor. The system consisted of two sections: software and apparatus (hardware). It was modified by using a group of light-dependent resistor sensors, and two DC servo motors were utilized to rotate the solar panel to a location with maximum sunlight. These components were arranged in a mechanical configuration with the gearbox. The three locations of the solar cell were chosen according to the tilt angle values, at zero angles, which included an optimal 33-degree angle for the Baghdad location and
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DBN Rashid, Talent Development & Excellence, 2020
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