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.
Spergularia iraqensis sp. nov. is described as a new species from Iraq. This species has been collected from Diyala Province in the central east of Iraq; it is closely related to Spergularia rubra (L.) J. Presl & C. Presl, 1819 and Spergularia bocconei (Scheele) Graebn., 1919.
The distinguishing of the morphological characteristics of the new species alongside the two similar species are discussed with photographs, and an identification key is given for Spergularia iraqensis and other closely related species.
Speech is the essential way to interact between humans or between human and machine. However, it is always contaminated with different types of environment noise. Therefore, speech enhancement algorithms (SEA) have appeared as a significant approach in speech processing filed to suppress background noise and return back the original speech signal. In this paper, a new efficient two-stage SEA with low distortion is proposed based on minimum mean square error sense. The estimation of clean signal is performed by taking the advantages of Laplacian speech and noise modeling based on orthogonal transform (Discrete Krawtchouk-Tchebichef transform) coefficients distribution. The Discrete Kra
Recently times, industrial development has increased, including plastic industries, and since plastic has a very long analytical life, it will cause environmental pollution. Therefore studies have resorted to reusing recycled plastic waste (sustainable plastic) to produce environmentally friendly concrete (green concrete). In this research, some studies were reviewed and then summarized into several things, including the percentage of plastic replacement from the aggregate and the effect of this percentage on the fresh properties of concrete, such as the workability and the effect of plastic waste on the hardening properties of concrete such as dry density, compressive, tensile and flexural strength.
ABSTRACT: BACKGROUND: Trivial number of books, concerning traditional medicine, had mentioned a galactagogual role of Garden cress seeds. Others ignore that. This controversy, in addition to the steroid (family of sex hormones) contents of the seeds, directed us to evaluate the role of this herb in mammogenesis and lactogenesis. METHODS: Twelve parameters were used to assess the effect of Garden cress seeds on the mammary gland of young adult virgin rats. These parameters comprise gross assessment, histological examination (routine/ haematoxylin and eosin stain and special stain/ PAS), enzymatic histochemical study (alkaline phosphatase, acid phosphatase and lipoprotein lipase cytochemical localization), biochemical estimations (hor
... Show MoreAbstract: In this research, nanofibers have been prepared by using an electrospinning method. Three types of polymer (PVA, VC, PMMA) have been used with different concentration. The applied voltage and the gap length were changed. It was observed that VC is the best polymer than the other types of polymers.
A study of the hadiths of supplication orchestration
The use of artificial intelligence (AI) technology is rapidly expanding in nursing and society. However, its use in healthcare comes with a number of challenges and concerns. The authors of this article use the sociotechnical model to consider the expanding use of AI in nursing and healthcare from a global perspective. Select references from the literature are used to support this important discussion for nurses and other healthcare professionals. Artificial intelligence is a major innovation that, if used properly, can reduce errors and improve efficiency and healthcare quality. It has also been shown to increase patient support, healthcare access and patient care. Here the authors address some of the limitations and challenges of
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