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.
A medical- service platform is a mobile application through which patients are provided with doctor’s diagnoses based on information gleaned from medical images. The content of these diagnostic results must not be illegitimately altered during transmission and must be returned to the correct patient. In this paper, we present a solution to these problems using blind, reversible, and fragile watermarking based on authentication of the host image. In our proposed algorithm, the binary version of the Bose_Chaudhuri_Hocquengham (BCH) code for patient medical report (PMR) and binary patient medical image (PMI) after fuzzy exclusive or (F-XoR) are used to produce the patient's unique mark using secret sharing schema (SSS). The patient’s un
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Cloud-based Electronic Health Records (EHRs) have seen a substantial increase in usage in recent years, especially for remote patient monitoring. Researchers are interested in investigating the use of Healthcare 4.0 in smart cities. This involves using Internet of Things (IoT) devices and cloud computing to remotely access medical processes. Healthcare 4.0 focuses on the systematic gathering, merging, transmission, sharing, and retention of medical information at regular intervals. Protecting the confidential and private information of patients presents several challenges in terms of thwarting illegal intrusion by hackers. Therefore, it is essential to prioritize the protection of patient medical data that is stored, accessed, and shared on
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Background: A carefully planned clinical medical education is critical for the provision of supportive clinical educational environment. The latter will ensure effective teaching, active learning and good attitudes and performance at the bedside. The aim of this study was to evaluate clinical learning environment at AL-Diwaniyah Teaching Hospital. Materials and Methods: A descripitive cross-sectional study involved resident doctors from Internal Medicine and Surgery departments who had six months or more residency training in the respective departments. Data were collected using the Postgraduate Hospital Educational Environment Measure. Data where analyzed using the Statistical Package for Social Sciences version 21.0 and presented us
... Show MoreThe fabrication of Solid and Hollow silver nanoparticles (Ag NPs) has been achieved and their characterization was performed using transmission electron microscopy (TEM), zeta potential, UV–VIS spectroscopy, and X-ray diffraction (XRD). A TEM image revealed a quasispherical form for both Solid and Hollow Ag NPs. The measurement of surface charge revealed that although Hollow Ag NPs have a zeta potential of -43 mV, Solid Ag NPs have a zeta potential of -33 mV. According to UV-VIS spectroscopy measurement Solid and Hollow Ag NPs both showed absorption peaks at wavelengths of 436 nm and 412 nm, respectively. XRD pattern demonstrates that the samples' crystal structure is cubic, similar to that of the bulk materials, with
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Abstract That the child is aged 7 years, surrounded by information, knowledge and skillsvaried, which constitute the raw material of experience teaching and is in the rule of inputlearning, if received by the student of these data are positive, these data require research and audit, the style becomes more positive, effective, and then becomes the explorer, butnot done exploration efficiency without the visual, auditory and sensory owned by thechildren. So study aimed to identify the values of the optical track and explore mathematical and find the relationship between them. And use the descriptive approach in a manner the linkon the children of the first year of primary school age (6-7) years in my school Waziriya and Karkh, during the peri
... Show MoreThe Ottomans ruled Turkey for nearly six centuries, during which the Ottoman Empire passed through varying periods in terms of strength, influence, and the area of land they ruled. In the last decade of its rule, the Ottoman Empire was severely weakened in all political, military, administrative and economic aspects. In addition to the internal strife that was stirred up by the leaders of the Association (Union and Progression), that organization that led the coup movement against the Ottoman Empire later.
After the abolition of the Sultanate and the proclamation of the Turkish Republic, the social fabric in Turkey changed, and many customs and traditions alien to it emerged to society. One of the thing
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