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 surgery Keywords: Non-surgical treatment of anal fissure, fissure in ano, sphicterotomy,botulinum toxin in anal fissures, glyceryl trinitrate. Chemical sphincteratomy, pharmacological sphincteratomy.
Praise be to God, and prayers and peace be upon our master Muhammad, the Messenger of God, and upon his family, companions, and those who are guided by his guidance.
Then:
Our Islamic jurisprudence and its basic principles are fixed, namely: the Noble Qur’an, then the Prophet’s Sunnah, then consensus, then analogy. However, it is characteristic of what makes it developed to meet the requirements of renewed life, including: sent interests, custom, approval, blocking pretexts, changing times. That is why it went through different stages, growth, brilliance, stagnation and endowment; Therefore, many scholars of Islamic jurisprudence divided its stages into four sections: the stage of inf
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PV connected systems are worldwide installed because it allows consumer to reduce energy consumption from the electricity grid. This paper presents the results obtained from monitoring a 1.1 kWp. The system was monitored for nine months and all the electricity generated was fed to the fifth floor for physics and renewable energy building 220 V, 50 Hz. Monthly, and daily performance parameters of the PV system are evaluated which include: average generated of system Ah per day, average system efficiency, solar irradiation around these months. The average generated kWh per day was 8 kWh/day, the average solar irradiation per day was 5.6 kWh/m2/day, the average inverter efficiency was 95%, the average modules efficien
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Background: Lung cancer is responsible for the most
cancer deaths in both men and women throughout the
world. Deaths from lung cancer (160,440 in 2004,
according to the National Cancer Institute) exceed the
number of deaths from four other major cancers combined
(breast, colon, pancreatic and prostate).
Objective: To assess the behavior and the approaches of
lung cancer in a sample of Iraqi patients.
Methods: This descriptive retrospective study was
performed using the records of 390 patients proved to have
lung cancer that had attending the Thoracic Surgery
Department of Surgical Specialties Hospital-Medical City
\Baghdad for the period from January, 1st
, 2001 to
December, 31st
,2002.
Res
Machine learning models have recently provided great promise in diagnosis of several ophthalmic disorders, including keratoconus (KCN). Keratoconus, a noninflammatory ectatic corneal disorder characterized by progressive cornea thinning, is challenging to detect as signs may be subtle. Several machine learning models have been proposed to detect KCN, however most of the models are supervised and thus require large well-annotated data. This paper proposes a new unsupervised model to detect KCN, based on adapted flower pollination algorithm (FPA) and the k-means algorithm. We will evaluate the proposed models using corneal data collected from 5430 eyes at different stages of KCN severity (1520 healthy, 331 KCN1, 1319 KCN2, 1699 KCN3 a
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Fiber-to-the-Home (FTTH) has long been recognized as a technology that provides future proof bandwidth [1], but has generally been too expensive to implement on a wide scale. However, reductions in the cost of electro-optic components and improvements in the handling of fiber optics now make FTTH a cost effective solution in many situations. The transition to FTTH in the access network is also a benefit for both consumers and service providers because it opens up the near limitless capacity of the core long-haul network to the local user. In this paper individual passive optical components, transceivers, and fibers has been put together to form a complete FTTH network. Then the implementation of the under construction Baghdad/Al
... Show MoreBetween the 1980s and 1990s, the HURIER model was developed by Brownell and consist of six interrelated components, which are represented in these acronyms (Hearing, Understanding, Remembering, Interpreting, Evaluating, and Responding). This model can be considered as a framework of the behavioral approach which can be used to improve students’ listening performance and to foster a positive attitude toward listening. Many learners find it challenging to improve their listening skills when learning a second or foreign language because it requires the integration of both listening and speaking. Consequently, enhancing this skill will help students improve other language skills, including reading, speaking, and writing. The HURI
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