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.
The 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.
The aim of this study was to know the inhibition activity of squeezed grape waste extract on Bacillus stearpthermophilus by using three different tempretures degree 40, 60 and 80c, in order to reduce the time exposure of food for preservation. This study include two branchs: First: isolation and identification of Bacillus stearothermophilus from soil, 5 sample were collected from the soil of the college agriculture/Baghdad university. Samples were cultured on nutrient agar, microscopic and culturing tests were conducted and many biochemical tests were done. The isolates were cultivated at 55 c and 65 c for differentiate it from Bacillus coagulans which is can't grow at 65 co. The c
... Show MoreZinc 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 MoreThe derivatives formed after the successive acetylation, esterification and nitration reactions to cholic, deoxycholic, and taurocholic acids were identified to be of the following general strucure: Colt, Where RI=NO3, OH, 0=, or CH3COO. R2=H, NO3, OH, 0-=, or CH3COO. R3=H, NO3,01-1, 0=, or CH3COO. R4=OH, NH(CH2)2S03Na, NH(CH2)2S03H, or OMe. By using U.V-visible and I.R spectrophotometry . The number of hydroxyl groups was determined, purity was checked from T.L.C, Most of these derivatives will find pharmaceutical application.
The right of the patient to know the medical risks surrounding the medical intervention is one of the most prominent rights based on the principle of "physical safety", which has undergone several stages of development until it reached the development of the patient's independence in making medical decision without relying on the doctor, The patient's prior informed consent is informed of his / her medical condition. We will study this development in accordance with the French March 4, 2002 legislation on the rights of patients in the health system, whether it was earlier and later. We will highlight the development of the patient's right to "know the medical risks surrounding medical intervention" The legislation and its comparison with th
... 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 MoreBackground: Scientific education aims to be inclusive and to improve students learning achievements, through appropriate teaching and learning. Problem Based Learning (PBL) system, a student centered method, started in the second half of the previous century and is expanding progressively, organizes learning around problems and students learn about a subject through the experience of solving these problems.Objectives:To assess the opinions of undergraduate medical students regarding learning outcomes of PBL in small group teaching and to explore their views about the role of tutors and methods of evaluation. Type of the study: A cross-sectional study.Methods: This study was conducted in Kerbala Medical Colleges among second year students
... 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
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