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.
An encryption system needs unpredictability and randomness property to maintain information security during transmission and storage. Although chaotic maps have this property, they have limitations such as low Lyapunov exponents, low sensitivity and limited chaotic regions. The paper presents a new improved skewed tent map to address these problems. The improved skew tent map (ISTM) increases the sensitivity to initial conditions and control parameters. It has uniform distribution of output sequences. The programs for ISTM chaotic behavior were implemented in MATLAB R2023b. The novel ISTM produces a binary sequence, with high degree of complexity and good randomness properties. The performance of the ISTM generator shows effective s
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This paper develops a fuzzy multi-objective model for solving aggregate production planning problems that contain multiple products and multiple periods in uncertain environments. We seek to minimize total production cost and total labor cost. We adopted a new method that utilizes a Zimmermans approach to determine the tolerance and aspiration levels. The actual performance of an industrial company was used to prove the feasibility of the proposed model. The proposed model shows that the method is useful, generalizable, and can be applied to APP problems with other parameters.
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PKE Sharquie MD, PDPAA Noaimi MD, DDV, FDSM Al-Ogaily MD, IOSR Journal of Dental and Medical Sciences (IOSR-JDMS), 2015
The aim of this paper is to identify Nano-particles that have been used in diagnosis and treatment of leishmaniasis in Iraq. All experiments conducted in this field were based on the following nanoparticles: gold nanoparticles, silver nanoparticles, zinc nanoparticles, and sodium chloride nanoparticles. Most of these experiments were reviewed in terms of differences in the concentrations of nanoparticles and the method that was used in the experiments whether it was in vivo or in vitro. These particles used in most experiments succeeded in inhibiting the growth of Leishmania parasites.
The present work includes a design and characteristics study of a controlling the wavelength of high power diode laser by thermoelectric cooler [TEC] . The work includes the operation of the [TEC] to control the temperature of the diode laser between ( 0- +30) °C by changing the resistance of thermistor. We can control a limited temperature of a diode laser by changing the phase cooling between hot and cold faces of the diode, this process can be attempted by comparator type [LM –311] .The theoretical results give a model for controlling the temperature with, the suitable wavelength.
The purpose of this interview study was to explore teachers’ perceptions of Response to Intervention (RtI) implementation in their school. Particularly, the study explored teachers’ knowledge of RtI, teachers’ perceptions of RtI their intervention/instruction in school, and teachers’ suggestions of RtI implementation in their school. The study design was a qualitative interview in nature and data were collected from face-to-face interviews with four teachers in one school. The findings revealed that RtI means to identify students’ problems; the positive teachers’ perceptions of their implementation included: (a) students who demonstrate progress through RtI are those who receive private education services, (b) progress monito
... Show MoreAbstract: Facial defects resulting from neoplasms, congenital, acquired malformations or trauma can be restored with facial prosthesis using different materials and retention methods to achieve life-like look and function. A nasal prosthesis can re-establish aesthetic form and anatomic contours for mid-facial defects, often more effectively than by surgical reconstruction as the nose is relatively immobile structure. For successful results, lot of factors such as harmony, texture, color matching and blending of tissue interface with the prosthesis are important. The aim of this study is to describe the non-surgical rehabilitation with nasal prosthesis for an Iraqi patient who received rhinectomy as a result of squamous cell carcinoma of the
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