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.
In this review, numerous analytical methods to distinguish pigments in tattoo, paint, and ink items are discussed. The selection of a method was dependent upon the purpose, e.g., quantification or identification of pigments. The introductory part of this review focuses on describing the importance of setting up a pigment-associated safety profile. The formation of different degradation chemical substances as well as impurity trends can be indicated through the chemical investigation of pigments in tattoo products. It is noteworthy that pigment recognition in tattoo inks can work as a preliminary method to identify the pigments in a patient's tattoo before being removed by laser therapy. Contrary to the stud
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The study objective was to summarize and evaluate the literature from the last decade about the cost of illness (COI) of diabetic retinopathy (DR) and diabetic macular edema (DME) through a systematic review.
Author conducted a search of the PubMed, and Google Scholar, electronic databases from January 2014 until July 2024, by identifying the following keywords ‘cost of illness,’ ‘economic burden,’ ‘diabetic retinopathy,’ and ‘diabetic m
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In this review, numerous analytical methods to distinguish pigments in tattoo, paint, and ink items are discussed. The selection of a method was dependent upon the purpose, e.g., quantification or identification of pigments. The introductory part of this review focuses on describing the importance of setting up a pigment-associated safety profile. The formation of different degradation chemical substances as well as impurity trends can be indicated through the chemical investigation of pigments in tattoo products. It is noteworthy that pigment recognition in tattoo inks can work as a preliminary method to identify the pigments in a patient's tattoo before being removed by laser therapy. Contrary to the stud
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Sensibly highlighting the hidden structures of many real-world networks has attracted growing interest and triggered a vast array of techniques on what is called nowadays community detection (CD) problem. Non-deterministic metaheuristics are proved to competitively transcending the limits of the counterpart deterministic heuristics in solving community detection problem. Despite the increasing interest, most of the existing metaheuristic based community detection (MCD) algorithms reflect one traditional language. Generally, they tend to explicitly project some features of real communities into different definitions of single or multi-objective optimization functions. The design of other operators, however, remains canonical lacking any inte
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Artificial intelligence has quickly invaded the realms of both creative and information-based writing, raising new questions about human originality, authorship and style. Despite its ability to produce writings that are coherent and stylistically varied, there are still concerns over the uniqueness and cultural neutrality of AI programs such as ChatGPT. This review covers significant recent advancements with artificial intelligence applications in both the literary and non-literary fields. It analyzes 35 recent studies contrasting authorship and creativity, or stylistic considerations and impressions, between human and AI texts. These studies range from poetic and fictional writing through essay, news article and academic publicati
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This study aimed to know the impact of the capital structure measured by the ratio of financing to short-term capital and the ratio of financing to long-term capital on the profitability of companies, as measured by the rate of return on assets and the rate of return on equity. The study was applied to industrial sector companies listed in the Iraq Stock Exchange. The financial number of (14) companies, and (4) companies were selected that met the conditions for selecting the study sample. The study methodology relies on the analytical method as it is more appropriate to the nature, scope and objectives of the study, and the ready-made statistical program "SPSS" will be used to analyze the relationships and influence between the
... Show MoreBACKGROUND: Vaccine hesitancy and reluctant had an important obstacle in achieving protection and population immunity against coronavirus disease 19 (COVID-19). It is essential to achieve high COVID-19 vaccination acceptance rates among medical students and health care workers to provide recommendations and counseling vaccine hesitant population. AIM: This study aims to identify level of COVID-19 hesitancy, attitude, knowledge, and factors that affect vaccination decision. MATERIALS AND METHODS: A cross-sectional study was done among medical students in Al-Kindy College of Medicine, University of Baghdad, Baghdad, Iraq. Data collection was done through an online Google Forms questionnaire during 2021 from 810 medical students.
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