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.
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Wireless sensor networks (WSNs) represent one of the key technologies in internet of things (IoTs) networks. Since WSNs have finite energy sources, there is ongoing research work to develop new strategies for minimizing power consumption or enhancing traditional techniques. In this paper, a novel Gaussian mixture models (GMMs) algorithm is proposed for mobile wireless sensor networks (MWSNs) for energy saving. Performance evaluation of the clustering process with the GMM algorithm shows a remarkable energy saving in the network of up to 92%. In addition, a comparison with another clustering strategy that uses the K-means algorithm has been made, and the developed method has outperformed K-means with superior performance, saving ener
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The investment portfolio of financial instruments & banking relatively new in the banking sector & the world of investment &capital markets in spite of its importance & its advantages in terms of the nature of the diversity of investment instruments as well as reduce the risk of investment & its contribution to the revitalization of the banks & the financial market , economic, &characterized by developments accelerated under information & communications technology , as is the portfolio tool vehicle of investment tools that provide for people who want to invest & they can not manag
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Microfluidic devices provide distinct benefits for developing effective drug assays and screening. The microfluidic platforms may provide a faster and less expensive alternative. Fluids are contained in devices with considerable micrometer-scale dimensions. Owing to this tight restriction, drug assay quantities are minute (milliliters to femtoliters). In this research, a microfluidic chip consisting of micro-channels carved on substrate materials built using an Acrylic (Polymethyl Methacrylate, PMMA) chip was designed using a Carbon Dioxide (CO2) laser machine. The CO2 parameters influence the chip’s width, depth, and roughness. To have a regular channel surface, and low roughness, the laser power (60 W), with scanning speed (250 m/s)
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Surface water samples from different locations within Tigris River's boundaries in Baghdad city have been analyzed for drinking purposes. Correlation coefficients among different parameters were determined. An attempt has been made to develop linear regression equations to predict the concentration of water quality constituents having significant correlation coefficients with electrical conductivity (EC). This study aims to find five regression models produced and validated using electrical conductivity as a predictor to predict total hardness (TH), calcium (Ca), chloride (Cl), sulfate (SO4), and total dissolved solids (TDS). The five models showed good/excellent prediction ability of the parameters mentioned
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Breast cancer is among the primary causes of death among Iraqi women and is a serious worldwide health concern. ALK or anaplastic lymphoma kinase, is connected to several cancers, including breast cancer.. The goal of this research was to assess the prevalence of anaplastic lymphoma kinase (ALK) with Alkaline phosphatise (ALP) and Lactate dehydrogenase (LDH) together as diagnostic markers. The study comprised 60 patients with metastatic breast cancer and 60 healthy volunteers. The blood levels of the enzymes (ALP), (LDH), and ALK in Iraqi breast cancer patients are compared to those of healthy controls. It was shown that compared to healthy people, patients had breast cancer noticeably greater levels of ALK, ALP, and NDH .These biomarkers m
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Psychological aspects are a major influence and motivation factor in many cinematic and television works such as television series. There are many films that dealt with psychological issues through the personality affected by psychological projections and complexes that lead towards abnormal behavior and actions in most cases, so the researchers chose the title and the research problem was raised through the following question: What is the mechanism that fulfills a psychological role in the narrative film? The objectives of the research were to reveal the mechanism used to instill psychological contents in the feature film? As for the limits of the research, it was an intentional sample, and the researchers adopted the descriptive anal
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