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.
Melanoma, a highly malignant form of skin cancer, affects individuals of all genders and is associated with high mortality rates, especially in advanced stages. The use of tele-dermatology has emerged as a proficient diagnostic approach for skin lesions and is particularly beneficial in rural areas with limited access to dermatologists. However, accurately, and efficiently segmenting melanoma remains a challenging task due to the significant diversity observed in the morphology, pigmentation, and dimensions of cutaneous nevi. To address this challenge, we propose a novel approach called DenseUNet-169 with a dilated convolution encoder-decoder for automatic segmentation of RGB dermascopic images. By incorporating dilated convolution,
... Show MoreBackground: pregnancy as a systemic condition causes changes in the functioning of human body as a whole and specifically in the oral cavity and it also is considered as a stressful condition. These changes may favor the increase of oxidative stress. Aim: The aim of this study was to estimate the level of marker of oxidative stress (malondialdehyde) and antioxidant (uric acid) in saliva of pregnant compared to non-pregnant women and to assess the gingival health condition in both groups. Additionally, unstimulated salivary flow rate was determined in both groups. Subjects, materials and methods: The study group consisted of sixty pregnant women, they were divided into three equal groups according to trimester (20 pregnant women for each
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The food web is a crucial conceptual tool for understanding the dynamics of energy transfer in an ecosystem, as well as the feeding relationships among species within a community. It also reveals species interactions and community structure. As a result, an ecological food web system with two predators competing for prey while experiencing fear was developed and studied. The properties of the solution of the system were determined, and all potential equilibrium points were identified. The dynamic behavior in their immediate surroundings was examined both locally and globally. The system’s persistence demands were calculated, and all conceivable forms of local bifurcations were investigated. With the aid of MATLAB, a numerical simu
... Show MoreThe research aims to evaluate the radioactivity in elected samples of cereals and legume which are wide human consumption in Iraq using Nuclear Track Detectors (NTDs) model CN-85.
The samples were prepared scientifically according to references in this field. After 150 days of exposure, the detector were collected and chemically treated according to scientific sources (etching chemical), nuclear effects have been calculated using the optical microscope.
Radon (222Rn) concentration and uranium (238U) were calculated in unit Bq/m3 and (ppm), the results indicate that the highest concentration of radon and uranium was in yellow corn where the concentration of radon was 137.17×102 Bq/m3 and uranium concentration 2.63 (ppm). The lowest
An evaluation the performance of the irrigation system for the Al-Ishaqi irrigation project for the Eastern Canal was conducted to identify management strategies that can be used to improve the operation and performance of the irrigation system. The study area is located in Salah al-Din G.0overnorate, Iraq. The field work included determining the moisture content of the soil before and after irrigation, measuring the inflow of the field to find the depth of the applied water, field monitoring, and measuring the depth of the root zone for each irrigation process. Field measurements showed that the average efficiency of water application for the two fields (A, and B) are 59.81% and 38.6%, respectively. The results of the efficiency of
... Show MoreTo identify and explore the factors nurses perceive as influencing their knowledge acquisition in relation to diabetes care and its management in Saudi Arabia.
Diabetes continues to pose major healthcare challenges despite advances in diabetes management. Nurses have a crucial role in diabetes care, but diabetes knowledge deficits deter effective collaboration with other healthcare providers in educating patients about diabetes self‐management.
An exploratory descriptive qualitative design.
Acute appendicitis is one of the commonest causes of acute abdomen. There is a wide discussion and controversy on the surgical and nonsurgical treatment of acute uncomplicated appendicitis. The aim of this study was to evaluate the efficacy and outcomes of the conservative management of selected cases of acute appendicitis with an antibiotic first plan.
This was a single hospital-based prospective study with a durat