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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Hepatitis, an inflammation of the liver, has a number of infectious and non-infectious causes. Two of the viruses that cause hepatitis (hepatitis A and E) can be transmitted through water and food; hygiene is therefore important in their control. First, to assess the importance of HAV and HEV as a possible diagnosis for clinically diagnosed patients with acute viral hepatitis. Second, to assess the prevalence of hepatitis A and E in all provinces of Iraq and study its association with age, gender. This study consisted of two groups: The first group consisted of 2975 patients with a clinical diagnosis of acute viral hepatitis. The second group consisted of a total of 9610 persons, which were recruited by surveying a nationally representative
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Among the available chaotic modulation schemes, differential chaos shift keying (DSCK) offers the perfect noise performance. The power consumption of DCSK is high since it sends chaotic signal in both of 1 and 0 transmission, so it does not represent the optimal choice for some applications like indoor wireless sensing where power consumption is a critical issue. In this paper a novel noncoherent chaotic communication scheme called differential chaos on-off keying (DCOOK) is proposed as a solution of this problem. With the proposed scheme, the DCOOK signal have a structure similar to chaos on-off keying (COOK) scheme with improved performance in noisy and multipath channels by introducing the concept of differential coherency used in DCS
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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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This article aims to explore the importance of estimating the a semiparametric regression function ,where we suggest a new estimator beside the other combined estimators and then we make a comparison among them by using simulation technique . Through the simulation results we find that the suggest estimator is the best with the first and second models ,wherealse for the third model we find Burman and Chaudhuri (B&C) is best.
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.
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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