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 surgeryKeywords: Non-surgical treatment of anal fissure, fissure in ano, sphicterotomy,botulinum toxin in anal fissures, glyceryl trinitrate. Chemical sphincteratomy, pharmacological sphincteratomy.
Ameloblastic fibroma is a rare benign tumor usually affects the first two decades of life. The neoplasm is more predominant in mandibular molar-premolar region and rarely affects the maxilla. In this report, we present a couple of Ameloblastic fibroma cases, affecting boys at their 1st decade. The lesions were presented as swellings of their maxilla, which is atypical location. Radiographic images showed well-defined radiolucency containing areas of radio-opacities and impacted teeth. Differential diagnosis was established as cystic/neoplastic conditions. The lesions were incised and histopathologically diagnosed as Ameloblastic fibroma, since they were composed of immature odontogenic mesenchymal and epithelial cells showing different c
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This paper deals with constructing mixed probability distribution from mixing exponential
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Collapsible soil has a metastable structure that experiences a large reduction in volume or collapse when wetting. The characteristics of collapsible soil contribute to different problems for infrastructures constructed on its such as cracks and excessive settlement found in buildings, railways channels, bridges, and roads. This paper aims to provide an art review on collapse soil behavior all over the world, type of collapse soil, identification of collapse potential, and factors that affect collapsibility soil. As urban grow in several parts of the world, the collapsible soil will have more get to the water. As a result, there will be an increase in the number of wetting collapse problems, so it's very important to com
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Today’s modern medical imaging research faces the challenge of detecting brain tumor through Magnetic Resonance Images (MRI). Normally, to produce images of soft tissue of human body, MRI images are used by experts. It is used for analysis of human organs to replace surgery. For brain tumor detection, image segmentation is required. For this purpose, the brain is partitioned into two distinct regions. This is considered to be one of the most important but difficult part of the process of detecting brain tumor. Hence, it is highly necessary that segmentation of the MRI images must be done accurately before asking the computer to do the exact diagnosis. Earlier, a variety of algorithms were developed for segmentation of MRI images by usin
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Active vibration control is the main problem in different structure. Smart material like piezoelectric make a structure smart, adaptive and self-controlling so, they are effective in active vibration control. In this paper piezoelectric elements are used as sensors and actuators in flexible structures for sensing and actuating purposes, and to control the vibration of a cantilever beam by using sliding mode control. The sliding mode controller (SMC) is designed to attenuate the vibration induced by initial tip displacement which is equal to 15 mm. It is designed based on the balance realization reduction method where three states are selected for the reduced model from the 24th states that describe the c
... Show MoreIn this paper , some of lexical stylistic , syntactical stylistic devices , and one phonetic stylistic device are going to be illustrated in the study of the aphorisms of “life and death” . These stylistic devices are parallelism , hyperbole , alliteration , meiosis , irony , oxymoron , cliché , litotes , metalepsis , and loose sentences. This paper aims at identifying the functions and the frequencies of these devices. These stylistic devices make one speech and writing more interesting and help to get the attention of readers/ listeners
Land snails constitute an important group of mollusks distributed worldwide. This study reports on land snails found in Iraq. A survey of terrestrial gastropods was performed during their activity seasons in gardens, agricultural lands and nurseries in Iraq from March 2022 to September 2023. Fifteen terrestrial snails belonging to seven families were documented. The species Euchondrus michonii (Bourguignat, 1853) was identified and recorded based on several distinct conchological characters for the first time in Iraq. The recently collected specimens, along with those previously recorded in Iraq, were included in this checklist. Essential information on each species is also presented. As there is no previous checklist or study that
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