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.
Fetal growth restriction is a significant contributor to fetal morbidity and mortality. In addition, there are heightened maternal risks associated with surgical operations and their accompanying dangers. Monitoring fetal development is a crucial objective of prenatal care and effective methods for early diagnosis of Fetal growth restriction, allowing prompt management and timely intervention to improve the outcomes. Screening for Fetal growth restriction can be achieved via many modalities; it can be medical, biochemical, or radiological. Some recommended combining more than one for better outcomes. Currently, there is inconsistency about the best method of Fetal growth restriction screening. In this review, a comprehensive
... 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 MoreReliable estimation of critical parameters such as hydrocarbon pore volume, water saturation, and recovery factor are essential for accurate reserve assessment. The inherent uncertainties associated with these parameters encompass a reasonable range of estimated recoverable volumes for single accumulations or projects. Incorporating this uncertainty range allows for a comprehensive understanding of potential outcomes and associated risks. In this study, we focus on the oil field located in the northern part of Iraq and employ a Monte Carlo based petrophysical uncertainty modeling approach. This method systematically considers various sources of error and utilizes effective interpretation techniques. Leveraging the current state of a
... Show MoreThis study aims at shedding light on the linguistic significance of collocation networks in the academic writing context. Following Firth’s principle “You shall know a word by the company it keeps.” The study intends to examine three selected nodes (i.e. research, study, and paper) shared collocations in an academic context. This is achieved by using the corpus linguistic tool; GraphColl in #LancsBox software version 5 which was announced in June 2020 in analyzing selected nodes. The study focuses on academic writing of two corpora which were designed and collected especially to serve the purpose of the study. The corpora consist of a collection of abstracts extracted from two different academic journals that publish for writ
... Show MoreThe purpose of the current investigation is to distinguish between working memory ( ) in five patients with vascular dementia ( ), fifteen post-stroke patients with mild cognitive impairment ( ), and fifteen healthy control individuals ( ) based on background electroencephalography (EEG) activity. The elimination of EEG artifacts using wavelet (WT) pre-processing denoising is demonstrated in this study. In the current study, spectral entropy ( ), permutation entropy ( ), and approximation entropy ( ) were all explored. To improve the classification using the k-nearest neighbors ( NN) classifier scheme, a comparative study of using fuzzy neighbourhood preserving analysis with -decomposition ( ) as a dimensionality reduction technique an
... Show MoreDetection of early clinical keratoconus (KCN) is a challenging task, even for expert clinicians. In this study, we propose a deep learning (DL) model to address this challenge. We first used Xception and InceptionResNetV2 DL architectures to extract features from three different corneal maps collected from 1371 eyes examined in an eye clinic in Egypt. We then fused features using Xception and InceptionResNetV2 to detect subclinical forms of KCN more accurately and robustly. We obtained an area under the receiver operating characteristic curves (AUC) of 0.99 and an accuracy range of 97–100% to distinguish normal eyes from eyes with subclinical and established KCN. We further validated the model based on an independent dataset with
... Show MoreCerium oxide (CeO2), or ceria, has gained increasing interest owing to its excellent catalytic applications. Under the framework of density functional theory (DFT), this contribution demonstrates the eect that introducing the element nickel (Ni) into the ceria lattice has on its electronic, structural, and optical characteristics. Electronic density of states (DOSs) analysis shows that Ni integration leads to a shrinkage of Ce 4f states and improvement of Ni 3d states in the bottom of the conduction band. Furthermore, the calculated optical absorption spectra of an Ni-doped CeO2 system shifts towards longer visible light and infrared regions. Results indicate that Ni-doping a CeO2 system would result in a decrease of the band gap. Finally,
... Show MoreThe Geographic Information System (GIS) is considered one of the most prominent programs used to collect, analyze, display, process, and produce geographic information maps for a specific purpose. It is also considered one of the modern database programs. Additionally, we can perform statistical analysis within GIS on predefined data to produce quantitative results. In this study, data was collected from more than 80 engineering projects established in Baghdad City from soil investigation reports for the projects. Geographic information systems were used to produce objective maps showing the variation in the bearing capacity of shallow foundations in the soil of Baghdad Governorate. I
Abstract:
The research aims to clarify the impact of adopting the IFRS16 financial reporting standard on lease contracts in insurance companies on audit procedures. The change in the classification of lease contracts in the case of adopting the IFRS16 financial reporting standard necessarily requires audit procedures that are compatible with this change. A proposed audit program was prepared, guided by international auditing standards, based on the study of the client's environment and analysis of external and internal risks in the light of financial and non-financial indicators. The researchers reached a set of concl
... Show MoreThe paper discusses the lack of a uniform definition of politeness due to the constant tension between its universality and language specificity, and argues that some of the theoretical debate could be resolved if the distinction between politeness as a commonsense notion and politeness as a theoretical construct were clearly addressed and acknowledged in the research.