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.
Plagiarism is becoming more of a problem in academics. It’s made worse by the ease with which a wide range of resources can be found on the internet, as well as the ease with which they can be copied and pasted. It is academic theft since the perpetrator has ”taken” and presented the work of others as his or her own. Manual detection of plagiarism by a human being is difficult, imprecise, and time-consuming because it is difficult for anyone to compare their work to current data. Plagiarism is a big problem in higher education, and it can happen on any topic. Plagiarism detection has been studied in many scientific articles, and methods for recognition have been created utilizing the Plagiarism analysis, Authorship identification, and
... Show MoreA retrospective study is conducted to identify factors that improve prospective animal studies; contribute to the optimization of animal protection from all unnecessary and preventable damage. Preclinical oral histology research from 2010-2020 is evaluated and 64 studies were reviewed relating to two interventions: bone trauma and surgical incision. The harm-benefit analysis is featured in this study through the application of the recent form of Bateson's Cube. Depending on its three axes, we can assess animal suffering, the likelihood of benefit, and the importance of research. The total number of animals used in the research is 2685. Rats, 51.6%, and rabbits, 48.4%, are the most commonly used animals. Research related to bone healing acco
... Show MoreThe present study cognitive aims to investigate the negation phenomenon in American political discourse under Critical Discourse Analysis (CDA) principles. The research sample includes two speeches given by Clinton and Trump in their election campaigns in 2016. Since the nature of the study follows the social-cognitive approach, the researcher adopted two models of analysis to achieve the study’s objectives: First, the theoretical framework of MST (developed by Fauconnier (1994), Fauconnier and Sweetser (1996) to examine meaning construction resulting from building different levels of negative mental spaces by two different genders the selected speeches. Second, pragmatic model to examine the role of gender from the functional per
... Show MoreDBN Rashid, Rimak International Journal of Humanities and Social Sciences, 2020
Machine learning models have recently provided great promise in diagnosis of several ophthalmic disorders, including keratoconus (KCN). Keratoconus, a noninflammatory ectatic corneal disorder characterized by progressive cornea thinning, is challenging to detect as signs may be subtle. Several machine learning models have been proposed to detect KCN, however most of the models are supervised and thus require large well-annotated data. This paper proposes a new unsupervised model to detect KCN, based on adapted flower pollination algorithm (FPA) and the k-means algorithm. We will evaluate the proposed models using corneal data collected from 5430 eyes at different stages of KCN severity (1520 healthy, 331 KCN1, 1319 KCN2, 1699 KCN3 a
... Show MoreFe, Co and Sb nanopowders were fruitfully prepared by electrical wire explosion method in Double distilled and de-ionized water (DDDW) media. The formation of iron, cobalt and antimony (FeCoSb) alloy nanopowder was monitored by X-ray diffraction. The x-ray diffraction pattern indicates that there are iron, cobalt and antimony peaks. Optical properties of this alloy nanoparticles were characterized by UV-Visible absorption spectra. The absorption peak position is shifted to the lower wavelengths when the current increases. That means the mean size of the nanoparticles controlled by changing the magnitude of the current. The surface morphological analysis is carried out by employing Scanning Electron Microscope (SEM). Particles with varies
... Show MoreThe spread of drugs in Iraq during the period 1932-1968 was one of the most dangerous. phenomena affecting humans, as it leads to addiction, to the point where people cannot live without it, it also leads to the destruction of the user's nerves and body, and the inability to maintain balance, or even perform daily tasks. There are different types of drugs, and the side effects vary from one type to another However in all cases, drugs remain the scourge of the world, They are a toxic substance that attacks the nerves and tries to destroy them' The importance of the subject lies in the fact that it is anew and unstudied topic, and it studies a phenomenon that affects humanity in general and Iraq in Particular through it light can be shed on t
... Show MoreThe study aims to identify the colleges women in the USA where he was browsing the Internet for five universities and sixty-two women's college located these colleges in 25 states only three general and other civil 51% supported by the churches and religious associations of various began its founding in Alqrnn eighteenth and continued in the nineteenth and twentieth and to provide an opportunity for women to complete higher education, while most men's colleges opened their doors to the admission of women and turned it on coeducation