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.
The fluctuation and expansion ratios have been studied for cylindrical gas-solid fluidized columns by using air as fluidizing medium and Paracetamol as the bed material. The variables were the column diameter (0.0762, 0.15, and 0.18 m), static bed height (0.05, 0.07, and 0.09 m), and air velocity to several times of minimum fluidization velocity. The results showed that both the fluctuation and expansion ratios had a direct relation with air velocity and an inverse one with column diameter and static bed height. A good agreement was between the experimental results and the calculated values by using the correlation equations from the literature.
Solvents are important components in the pharmaceutical and chemical industries, and they are increasingly being used in catalytic reactions. Solvents have a significant influence on the kinetics and thermodynamics of reactions, and they can significantly change product selectivity. Solvents can influence product selectivity, conversion rates, and reaction rates. However, solvents have received a lot of attention in the field of green chemistry. This is due to the large amount of solvent that is frequently used in a process or formulation, particularly during the purification steps. However, neither the solvent nor the active ingredient in a formulation is directly responsible for the reaction product's composition. Because these ch
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Background: Congenital club foot is a complex deformity of foot .It is a collection of different abnormalities, with different etiologies. Consequently, Severity varies with difficulties in evaluating treatment strategies with outcome results. The treatment of congenital club foot remains controversial. Usually, the orthopedist's goal is to obtain anatomically and functionally normal feet in all patients. Objective: To asses short term follow up result of conservatively treated club feet in relation to the age of initial casting by Ponseti technique. Methods :A cross sectional observational study with some comparative content done in Al-kindy
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Cryptographic applications demand much more of a pseudo-random-sequence
generator than do most other applications. Cryptographic randomness does not mean just
statistical randomness, although that is part of it. For a sequence to be cryptographically
secure pseudo-random, it must be unpredictable.
The random sequences should satisfy the basic randomness postulates; one of them is
the run postulate (sequences of the same bit). These sequences should have about the same
number of ones and zeros, about half the runs should be of length one, one quarter of length
two, one eighth of length three, and so on.The distribution of run lengths for zeros and ones
should be the same. These properties can be measured determinis
Background : Hyperglycosylated hCG a newly discovered variant of hCG which can be used as a predictor of invasion of trophoblastic cells in patient with gestational trophoblastic disease. Objectives : To measure hyperglycosylated human chorionic gonadotrophin and to assess how far it can be used as predictor of invasion in invasive mole and choriocarcinoma. Study design control study. Setting: : Case Gynecological department in Baghdad Teaching Hospital from January 2016 to January 2017. Patient and Methods : 60 women were enrolled in this study 30 of them were with gestational trophoblastic disease (no.= 30 ) the remainder were normal pregnancy (no. =30) , hCG –H level was measured in both groups. Results : Mean serum hCG-H le
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It is well known that the spread of cancer or tumor growth increases in polluted environments. In this paper, the dynamic behavior of the cancer model in the polluted environment is studied taking into consideration the delay in clearance of the environment from their contamination. The set of differential equations that simulates this epidemic model is formulated. The existence, uniqueness, and the bound of the solution are discussed. The local and global stability conditions of disease-free and endemic equilibrium points are investigated. The occurrence of the Hopf bifurcation around the endemic equilibrium point is proved. The stability and direction of the periodic dynamics are studied. Finally, the paper is ended with a numerical simul
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