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.
Background: 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 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.
Zinc 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 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 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
... Show MoreObjective(s): To evaluate teachers’ performance of counseling for pupils with Attention Deficit and Hyperactivity Disorder, to identify the relationship between Teachers’ Performance of Counselling for Pupils with Attention Deficit and Hyperactivity Disorder and their demographic.
Methodology: A quasi-experimental (pre-posttest) design was carried out to evaluate teachers’ performance of counseling for pupils with Attention Deficit and Hyperactivity Disorder, at Al-Firdous mixed primary School and to find out the association between teachers' performance about Attention Deficit and Hyperactivity Disorder and their socio-demographic characteristic. The study was started from 18th September 2
... Show MoreKE Sharquie, AA Noaimi, SD Hameed, Journal of Cosmetics, Dermatological Sciences and Applications, 2013 - Cited by 15
This study can be considered as un introduction to the idioms and the strategy about the productive partnership development connection, that helps the researcher and the organization in their work in to activate development and the natural sources,manegment,to improve the two sides active connected to the local society, and to use it as easier and smoother participation of the people who work in development field and the natural sources management research, That connection depends mostly upon the capability of researcher and the development worker to increase the ability of individual and local society to specify and analyzing their problems and to try solutions to make their life better with good income.
Abstract :
The aim of the study is to diagnose the level and nature of the relationship between cognitive interactions, cognitive ignorance and the achievement of strategic excellence). The aim of this is to explore theoretical philosophy and intellectual implications of these variables, and, then test the correlation and impact relationships and their feasibility in the application environment, which was formed from the seven directorates in the Ministry of Education. The sample of the study was determined by the directors, their assistants, and the department directors. The sample number is (130). The importance of the study is to come out with a philosophical basis for the nature of the variables, based on an app
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