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.
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Semantic segmentation is an exciting research topic in medical image analysis because it aims to detect objects in medical images. In recent years, approaches based on deep learning have shown a more reliable performance than traditional approaches in medical image segmentation. The U-Net network is one of the most successful end-to-end convolutional neural networks (CNNs) presented for medical image segmentation. This paper proposes a multiscale Residual Dilated convolution neural network (MSRD-UNet) based on U-Net. MSRD-UNet replaced the traditional convolution block with a novel deeper block that fuses multi-layer features using dilated and residual convolution. In addition, the squeeze and execution attention mechanism (SE) and the s
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The internet has been a source of medical information, it has been used for online medical consultation (OMC). OMC is now offered by many providers internationally with diverse models and features. In OMC, consultations and treatments are available 24/7. The covid-19 pandemic across-the-board, many people unable to go to hospital or clinic because the spread of the virus. This paper tried to answer two research questions. The first one on how the OMC can help the patients during covid-19 pandemic. A literature review was conducted to answer the first research question. The second one on how to develop system in OMC related to covid-19 pandemic. The system was developed by Visual Studio 2019 using software object-oriented approach. O
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Background: The gene encoding a disintegrin and metalloproteinase domain 33 (ADAM33) is known to be associated with asthma in different ethnic groups. In Iraq, among the Arab ethnic background, this association has not yet been highlighted. Methods: One hundred and ninety-two asthmatics were examined; 118 males and 74 females (mean age 38.23 ± 9.13 years). The control group was 183; 110 males and the rest were females. The SNP of rs2280091 A/G (T1) was studied here to determine adam33 genotyping status using polymerase chain reaction–restriction fragment length polymorphism (PCR–RFLP). The level of total IgE was measured using enzyme-linked immunosorbent assay (ELISA). Results: Significant differences (p = 0.004) in the frequencies of
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Mosquitoes play a serious role on public health transmitting several dangerous diseases such as malaria, filariasis and Encephalitis. So it consider as a vector diseases. Therefor it is important to control its spread using ecology friend’s factors like bacteria Bacillus thuringiensis var. israelensis and fungi Beauveria bassiana. Results revealed that the direct effect of Bacillus thuringiensis on the larvae led to the high mortality (100%) during 3 days while Beauveria bassiana have a cumulative effect on the Mosquito stage lifecycle; 7.3 X 104 more significant effect in the first day but there was no significant in the other days of treatment. In the end period of lifecycle there was no adult emergence and the adult which emergence up
... Show MoreThe research aims to identify the theoretical framework of technical reserves in the insurance activity and the role of the auditor in verifying the integrity of the estimates of technical provisions (technical reserves) for the branches of general insurance in insurance companies based on the relevant international auditing standards, as a proposed audit program has been prepared in accordance with international auditing standards that enable the auditor to express a sound opinion on the fairness of the financial statements of these companies , The research has reached many conclusions, the most important of which is the existence of deficiencies in the audit procedures of insurance companies, as the audit program of those companies did
... Show MoreThe present study aims to identify the role of behavioral disorders (anxiety disorder, behavior disorder "behavior", confrontation and challenge disorder, aggressive behavior) in predicting bullying patterns (verbal, physical, electronic, school) in a sample of adolescents with autism spectrum disorder. For this purpose, the researcher developed scales to measure the behavioral disorders and the bullying patterns among adolescents with autism spectrum disorder. The researcher adopted the descriptive survey approach. The study sample consists of (80) adolescents with autism spectrum disorder with ages range from (15-19 years) and (45-53 years old) in association with israr association for people with special needs in the northern borders
... Show MoreHair is an excellent indicator for abnormal concentration of toxic elements , In this study a random samples from girls hair of 12 cm long were irradiated by a flux of neutrons (4x10^ n/ cm^.s) obtained from an Am-Be neutron source of 5-Ci activitity . The y-ray activity measurements were carried out by using a " 5x5 " well- type Nal (Tl) detector. The study indicates clearly that the maximum concentration of elements was at about 7 cm hair length.