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 using of the parametric models and the subsequent estimation methods require the presence of many of the primary conditions to be met by those models to represent the population under study adequately, these prompting researchers to search for more flexible models of parametric models and these models were nonparametric models.
In this manuscript were compared to the so-called Nadaraya-Watson estimator in two cases (use of fixed bandwidth and variable) through simulation with different models and samples sizes. Through simulation experiments and the results showed that for the first and second models preferred NW with fixed bandwidth fo
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Synthetic anti-TB drugs are being used to treat tuberculosis (TB) as they are effective, however, they are accompanied by many side effects. The disease has remained largely uncured till date. The use of plant extracts or phytochemicals along with the anti-TB drugs is a very attractive strategy to make the treatment more effective as phytochemicals have no side-effects, are much less toxic than synthetic anti-TB drugs, are safe to use and most importantly, do not produce resistant strains as opposed to synthetic anti-TB drugs. Approximately 420,000 plant species have been identified globally and among them only a few have been explored for their therapeutic potential. Traditional medicine in different parts of the world has employed crud
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The CdS quantum dots were prepared by chemical reaction
of cadmium oleylamine (Cd –oleylamine complex) with the
sulfite-oleylamine (S-oleylamine) with 1:6 mole ratios. The
optical properties structure and spectroscopy of the product
quantum dot were studied. The results show the dependence of the
optical properties on the crystal dimension and the formation of
the trap states in the energy band gap.
Objective: To determine the effectiveness of a dietary educational program upon the hypertensive client’s
information.
Methodology: The sample of the study consists of (60) hypertensive clients who attended Al Anbar Health Office –Al
Andalus Health Center during the period of the study from the14th of March 2010 to the 30th of September 2010. The
sample is divided into two groups; study group (30) hypertensive clients who received dietary educational program
and control group (30) hypertensive clients who received a routine care from the center. Three major instruments
were used; these instruments included (1) knowledge test which was applied on both groups pretest and eight weeks
post-test (2) questions to know
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In this paper, a mathematical model was built for the supply chain to reduce production, inventory, and transportation in Baghdad Company for Soft Drink. The linear programming method was used to solve this mathematical model. We reduced the cost of production by reduced the daily work hours, the company do not need the overtime hours to work at the same levels of production, and the costs of storage in the company's warehouses and agents' stores have been reduced by making use of the stock correctly, which guarantees reducing costs and preserving products from damage. The units transferred from the company were equal to the units demanded by the agents. The company's mathematical model also achieved profits by (84,663,769) by re
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Today’s modern medical imaging research faces the challenge of detecting brain tumor through Magnetic Resonance Images (MRI). Normally, to produce images of soft tissue of human body, MRI images are used by experts. It is used for analysis of human organs to replace surgery. For brain tumor detection, image segmentation is required. For this purpose, the brain is partitioned into two distinct regions. This is considered to be one of the most important but difficult part of the process of detecting brain tumor. Hence, it is highly necessary that segmentation of the MRI images must be done accurately before asking the computer to do the exact diagnosis. Earlier, a variety of algorithms were developed for segmentation of MRI images by usin
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Active vibration control is the main problem in different structure. Smart material like piezoelectric make a structure smart, adaptive and self-controlling so, they are effective in active vibration control. In this paper piezoelectric elements are used as sensors and actuators in flexible structures for sensing and actuating purposes, and to control the vibration of a cantilever beam by using sliding mode control. The sliding mode controller (SMC) is designed to attenuate the vibration induced by initial tip displacement which is equal to 15 mm. It is designed based on the balance realization reduction method where three states are selected for the reduced model from the 24th states that describe the c
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