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.
<p>In combinatorial testing development, the fabrication of covering arrays is the key challenge by the multiple aspects that influence it. A wide range of combinatorial problems can be solved using metaheuristic and greedy techniques. Combining the greedy technique utilizing a metaheuristic search technique like hill climbing (HC), can produce feasible results for combinatorial tests. Methods based on metaheuristics are used to deal with tuples that may be left after redundancy using greedy strategies; then the result utilization is assured to be near-optimal using a metaheuristic algorithm. As a result, the use of both greedy and HC algorithms in a single test generation system is a good candidate if constructed correctly. T
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The increasing availability of computing power in the past two decades has been use to develop new techniques for optimizing solution of estimation problem. Today's computational capacity and the widespread availability of computers have enabled development of new generation of intelligent computing techniques, such as our interest algorithm, this paper presents one of new class of stochastic search algorithm (known as Canonical Genetic' Algorithm ‘CGA’) for optimizing the maximum likelihood function strategy is composed of three main steps: recombination, mutation, and selection. The experimental design is based on simulating the CGA with different values of are compared with those of moment method. Based on MSE value obtained from bot
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أثر تنوع الرؤى الاخراجية للاتجاهات والحركات المسرحية المعاصرة في أتساعالاشتراطات الجمالية لبنية الخطاب المسرحي + الامر الذي ادى الى انزياح مكوناتالعرض وعناصره ؛ ومنها المنظومة السردية للنص التي شكلت في بدايات المسرحجغرافية العرض المسرحي والمرتكز النظري والفكري الذي يمد العرض المسرحي أغلبتدفقه الجمالي وعنصر أستعلائي لعناصر العرض الاخرى ؛ وضمن التطورات اللاحقةأنسحب المخرج المسرحي من سطوة البنية النص
... Show MoreCopper (I) complex containing folic acid ligand was prepared and characterized on the basis of metal analyses, UV-VIS, FTIR spectroscopies and magnetic susceptibility. The density functional theory (DFT) as molecular modeling calculations was used to determine the donor atoms of folic acid ligand which appear clearly at oxygen atoms binding to hydrogen. Detection of donation sights is supported by theoretical parameters such as geometry, mulliken population, mulliken charge and HOMO-LUMO gap obtained by DFT calculations.
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The present study introduces description of new species of leafhopper Cicadella latreilla nov. External morphological characters particularly female genitalia were discussed and illustrated, shape of male abdominal apodeme, chaetotaxy of genital style and genital plate of male genitalia, shape of Aedeagus and connective . The external morphological characters were: spotting patterns of vertex, face, pronotum of prothorax, and metothorax, and of lower and upper valves of ovipositors,shape of female seventh abdominasternum.
In the current analysis, the effects of circumferential scratches along the inner surface of a 170ᵒ -arc partial journal bearing has been numerically investigated. Their impact on the thermo-elasto-hydrodynamic performance characteristics, including maximum pressure, temperature, deformation, and stress, has been examined thoroughly. The ANSYS Fluent CFD commercial code was employed to tackle the iterative solution of flow and heat transfer patterns in the fluid film domain. They are then applied to the ANSYS Static Structure solver to compute the deformation and stress resulted in the solid bearing zone. A wide range of operating conditions has been considered, including the eccentricity ratio ( ) and scratch depth (
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The condition known as hypothyroidism is common in women, even in those who are fertile. The quantity and caliber of follicles present in the ovary at any one moment are known as the ovarian reserve. Individuals who are susceptible to a decreased ovarian reserve ought to have an assessment of their ovarian reserve conducted. The purpose of this research is to assess the impact of hypothyroidism on Iraqi women's ovarian reserve using Inhibin B hormone and hormone tests FSH, LH. There was no discernible variation in the average (±SD) age from (20 to 40) years of the patient group compared to the control group (p-value 0.08). However the mean BMI of the patients were statistically significantly different from the controls (P- value 0.006).Wom
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The research aims to evaluate the radioactivity in elected samples of cereals and legume which are wide human consumption in Iraq using Nuclear Track Detectors (NTDs) model CN-85.
The samples were prepared scientifically according to references in this field. After 150 days of exposure, the detector were collected and chemically treated according to scientific sources (etching chemical), nuclear effects have been calculated using the optical microscope.
Radon (222Rn) concentration and uranium (238U) were calculated in unit Bq/m3 and (ppm), the results indicate that the highest concentration of radon and uranium was in yellow corn where the concentration of radon was 137.17×102 Bq/m3 and uranium concentration 2.63 (ppm). The lowest
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