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.
In this review, previous studies on the synthesis and characterization of the metal Complexes with paracetamol by elemental analysis, thermal analysis, (IR, NMR and UV-Vis (spectroscopy and conductivity. In reviewing these studies, the authors found that paracetamol can be coordinated through the pair of electrons on the hydroxyl O-atom, carbonyl O-atom, and N-atom of the amide group. If the paracetamol was a monodentate ligand, it will be coordinated by one of the following atoms O-hydroxyl, O-carbonyl or N-amide. But if the paracetamol was bidentate, it is coordinated by atoms (O-carbonyl and N-amide), (O-hydroxyl and N-amide) or (O-carbonyl and O-hydroxyl). The authors also found that free paracetamol and its complexes have antimicrobial
... Show MoreThe study included gross morphology and pollen of plants – which collected during field trips , and dry ones for most specimen preserved with the Iraqi herbaria – related to the genus Lycopus L. , and to identify the unidentified species and rectify the error there in , so according to that the species L. europaeus L. only were specified for the genus . Through this work the varity L. europaeus var. glabrescens Schmidely were found at the first time , and suggested to record anew for Iraq . Pollen were of medium size, and had an ellipsoid shape in the equatorial view , and hexagonal in the polar view. The ecological and soil quality where these genus plants grows were specified , and were geographically distribut
... Show MoreA QR code is a type of barcode that can hold more information than the familiar kind scanned at checkouts around the world. The “QR” stands for “Quick Response”, a reference to the speed at which the large amounts of information they contain can be decoded by scanners. They are being widely used for advertising campaigns, linking to company websites, contest sign-up pages and online menus. In this paper, we propose an efficient module to extract QR code from background and solve problem of rotation in case of inaccurate image taken from mobile camera.
Our goal in the present paper is to recall the concept of general fuzzy normed space and its basic properties in order to define the adjoint operator of a general fuzzy bounded operator from a general fuzzy normed space V into another general fuzzy normed space U. After that basic properties of the adjoint operator were proved then the definition of fuzzy reflexive general fuzzy normed space was introduced in order to prove that every finite dimensional general fuzzy normed space is fuzzy reflexive.
The utilization of sugarcane molasses (SCM), a byproduct of sugar refining, offers a promising bio-based alternative to conventional chemical admixtures in cementitious systems. This study investigates the effects of SCM at five dosage levels, 0.25%, 0.50%, 0.75%, 1.00%, and 1.25% by weight of cement, on cement mortar performance across fresh, mechanical, thermal, durability, and density criteria. A comprehensive experimental methodology was employed, including flow table testing, compressive strength (7, 14, and 28 days) and flexural strength measurements, embedded thermal sensors for real-time hydration monitoring, water absorption and chloride ion penetration tests, as well as 28-day density determination. Results revealed clear
... Show MoreThis paper proposes a self organizing fuzzy controller as an enhancement level of the fuzzy controller. The adjustment mechanism provides explicit adaptation to tune and update the position of the output membership functions of the fuzzy controller. Simulation results show that this controller is capable of controlling a non-linear time varying system so that the performance of the system improves so as to reach the desired state in a less number of samples.
Background: Nursing interventions tailored to the smoking triggers in patients with non-communicable chronic diseases are essential. However, these interventions are scant due to the nature of factors associated with smoking cessation and the poor understanding of the effect of nurse-led intervention in Iraq.Purpose: This study aimed to determine the dominant smoking triggers and examine the effects of a tailored nursing intervention on smoking behavior in patients with non-communicable chronic diseases.Methods: Convenience samples of 128 patients with non-communicable chronic diseases, male and female patients, who were 18-70 years old, were recruited in this quasi-experimental, randomized comparative trial in the outpatient clinic
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