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.
Background: Although mammography is a powerful screening tool in detection of early breast cancer, it is imperfect, particularly for women with dense breast, which have a higher risk to develop cancer and decrease the sensitivity of mammogram, Automated breast ultrasound is a recently introduced ultrasonography technique, developed with the purpose to standardize breast ultrasonography and overcome some limitations of handheld ultrasound, this study aims to evaluate the diagnostic efficacy of Automated breast ultrasound and compare it with handheld ultrasound in the detection and characterization of breast lesions in women with dense breasts.
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... Show MoreThis paper investigates a new approach to the rapid control of an upper limb exoskeleton actuator. We used a mathematical model and motion measurements of a human arm to estimate joint torque as a means to control the exoskeleton’s actuator. The proposed arm model is based on a two-pendulum configuration and is used to obtain instantaneous joint torques which are then passed into control law to regulate the actuator torque. Nine subjects volunteered to take part in the experimental protocol, in which inertial measurement units (IMUs) and a digital goniometer were used to measure and estimate the torque profiles. To validate the control law, a Simscape model was developed to simulate the arm model and control law in which measurem
... Show MoreA Stereomicroscopic Evaluation of Four Endodontic Sealers Penetration into Artificial Lateral Canals Using Gutta-Percha Single Cone Obturation Technique, Omar Jihad Banawi*, Raghad
Polarization manipulation elements operating at visible wavelengths represent a critical component of quantum communication sub-systems, equivalent to their telecom wavelength counterparts. The method proposed involves rotating the optic axis of the polarized input light by an angle of 45 degree, thereby converting the fundamental transverse electric (TE0) mode to the fundamental transverse magnetic (TM0) mode. This paper outlines an integrated gallium phosphide-waveguide polarization rotator, which relies on the rotation of a horizontal slot by 45 degree at a wavelength of 700 nm. This will ultimately lead to the conception of a mode hybridization phenomenon in the waveguide. The simulation results demonstrate a polarization co
... Show MoreThis Study presents and provides Variable thoughts and aspects for representing Scientific topics " Physics for instance " as Play Shows for high School Students, by Showing a suggested Method that will Contribute in illustrating the Steps of writing the educational Scientific topic, and this method will help teachers to deliver their message to the Students " receivers " easily.The researcher have used Puppets in this method as the assisting tool for teachers, to help them deliver message Clearlym easily and Joyful.The researcher in his experiment used " Archimedes Principle " as a typical example, by Converting it into a theatrical Script, with respect to the Concept of Science, and in accordance to the Scientific educational Curriculu
... Show MoreOur aim was to investigate the changes in the myocardium stiffness index for patients suffering from systemic hypertension, and to assess their left ventricular performance. We studied 263 hypertensive patients and 166 healthy subjects as a control group. By using conventional Doppler echocardiography, the following parameters were measured—Left ventricular end diastolic diameter, left ventricular end systolic diameter, transmitral early velocity, isovolumic relaxation time, and isovolumic contraction time. Tissue Doppler imaging (TDI) was used in the measurements of the early mitral annular velocity (Ea) and the diastolic stiffness was obtained by calculating the ratio E\Ea\LVIDd. Index myocardial performance (IMP) was calculated
... Show Moreأن التطور العلمي الحاصل فيما يخص المجال الرياضي أرسى آفاق جديدة لمواكبة التطور الكبير في مجا ل الألعاب والفعاليات الرياضية المختلفة ,و أن تحقيق النتائج الجيدة في فعاليات العاب القوى بشكل عام والثلاثية بشكل خاص في التدريب الرياضي يتطلب إتباع الأساليب العلمية الدقيقة والموضوعية بشكل سليم ومخطط له،فضلا عنة تطبيق نظريات ومنحى جديد لمواكبة الاتجاهات الحديثة في تحقيق النتائج الجيدة للوصول إلى المستويات العالية
... Show MoreStabilization of phenol trapped by agricultural waste: a study of the influence of ambient temperature on the adsorbed phenol
The study discussed here deals with the isolation of Aspergillus niger from palm dates, the formal and the most famous fruit in Iraq, to test and qualify this fungus isolate for its ability to produce citric acid. Submerged fermentation technique was used in the fermentation process. A.niger isolated from “Zahdi” Palme dates was used in the study of the fermentation kinetics to get the production efficiency of citric acid. Kinetics of CA production via fermentation by A. niger S11 was evaluated within 432 h fermentation time and under submerged conditions of 11% (w/v) sucrose, 5% (v/v) inoculum size, pH 4, 30 °C and 150 rpm. The maximum citric acid produced was (37.116 g/l). Kine