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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Air pollution is very important topic for those interested in studying the environment because of its importance and the damage caused by it to human, animal and plant life. This research addresses the concept of air pollution, its causes, and its danger, and sheds light on the influence of climate elements on environmental pollution and the effect of temperature, rain, humidity, wind direction and speed, and atmospheric pressure on the increase or decrease of air pollution. This research discusses the sources of air pollution, including natural ones, including dust, smoke resulting from fires, erupting volcanoes, and others, including those resulting from human uses such as the use of fuel and others. The research addressed the dam
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Numeral recognition is considered an essential preliminary step for optical character recognition, document understanding, and others. Although several handwritten numeral recognition algorithms have been proposed so far, achieving adequate recognition accuracy and execution time remain challenging to date. In particular, recognition accuracy depends on the features extraction mechanism. As such, a fast and robust numeral recognition method is essential, which meets the desired accuracy by extracting the features efficiently while maintaining fast implementation time. Furthermore, to date most of the existing studies are focused on evaluating their methods based on clean environments, thus limiting understanding of their potential a
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In this work, a simulated study was carried out for designing a novel spiral rectangular patch of microstrip antenna that is used in ultra-wideband applications by using a high frequency structure simulator software (HFSS). A substrate with dielectric constant of 4.4 and height 2.10 mm (commercial substrate height available is about 0.8-1.575 mm) has been used for the design of the proposed antenna. The design basis for enhancing bandwidth in the frequency range 6.63 - 10.93 GHz is based on increasing the edge areas that positively affect the antenna's efficiency. This design makes the designed antenna cost less by reducing the area of the patch. It has been noticed that the bandwidth of the antenna under this study is increasing to 4.30
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SJ Mohammed, AA Noaimi, KE Sharquie, JM Karhoot, MS Jebur, JR Abood, A Al-Hamadani, Al-Qadisiyah Medical Journal, 2015 - Cited by 20
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