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.
The research (Anthropology and Representations of magic in Arab Theatrical Text, Harut and Marut's play as a Model) is concerned with studying magic and the forms of its presence in the theatrical text in different human cultures where it belongs. The research consists of four chapters.
The first chapter includes the research problem that revolves around the following questions: (what is the mechanism of employing magic anthropology and its representations in the Arab theatrical text Harut and Marut's play as a model?), and the research importance which is attributed to the necessity of studying (magic) in the Arab theatrical text as it is considered the inauguration of one of the social phenomena that many researchers in the field o
A comparative study was carried out on ecological and genetical adaptation of three Iraqi
freshwater snails, Physa acuta, Melanopsis buccinoidea and Melanoides tuberculata, in
respect to acute toxicity of heavy metals (Zn, Cd and Hg). Longevity are used as poisoning
tolerance criterion. LT 50 and LT 100 were determined for the studied snails at (0.5, 1, 5, and
10 ppm), for the three metals. Results indicated that Physa acuta had a higher tolerance than
Melanopsis buccinoidea and Melanoides tuberculata, which was the lower one. Previous
exposure to heavy metals in the original habitat was affecting on experimental tolerance and
no relationships of physical and chemical factors (total hardness, temperature, D. O. and
The osseodensification (OD) drilling technique was suggested as an alveolar ridge expansion technique, so the aim of this prospective clinical study was to evaluate the amount of bone expansion obtained by the OD drilling technique and its effect on implant stability in patients with narrow alveolar ridges. The width of the alveolar ridge was measured at the crest before and after implant site preparation, whereas the implant stability was measured using Osstell Beacon implant stability quotient (ISQ). The ISQ values were recorded immediately postoperatively and after 16 weeks. Twenty-three patients were included; they received 40 implants. The mean (± standard deviation [SD]) amount of expansion was 1.29 (± 0.41) mm, and the difference b
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Background: The roles of AI in the academic community continue to grow, especially in the enhancement of learning outcomes and the improvement of writing quality and efficiency. Objectives: To explore in depth the experience of senior pharmacy students in using artificial intelligence for academic purposes. Methods: This qualitative study included face-to-face individual interviews with senior pharmacy students from March to May 2023 using a pre-planned interview guide of open-ended questions. All interviews were audio-recorded. Thematic analysis was used to analyze the data. Results: The results were obtained from 15 in-depth face-to-face interviews with senior pharmacy students (5th and 4th years). Eight participants were male, and seven
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Background: The roles of AI in the academic community continue to grow, especially in the enhancement of learning outcomes and the improvement of writing quality and efficiency. Objectives: To explore in depth the experience of senior pharmacy students in using artificial intelligence for academic purposes. Methods: This qualitative study included face-to-face individual interviews with senior pharmacy students from March to May 2023 using a pre-planned interview guide of open-ended questions. All interviews were audio-recorded. Thematic analysis was used to analyze the data. Results: The results were obtained from 15 in-depth face-to-face interviews with senior pharmacy students (5th and 4th years). Eight participants were male, an
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In this paper, several combination algorithms between Partial Update LMS (PU LMS) methods and previously proposed algorithm (New Variable Length LMS (NVLLMS)) have been developed. Then, the new sets of proposed algorithms were applied to an Acoustic Echo Cancellation system (AEC) in order to decrease the filter coefficients, decrease the convergence time, and enhance its performance in terms of Mean Square Error (MSE) and Echo Return Loss Enhancement (ERLE). These proposed algorithms will use the Echo Return Loss Enhancement (ERLE) to control the operation of filter's coefficient length variation. In addition, the time-varying step size is used.The total number of coefficients required was reduced by about 18% , 10% , 6%
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Absence or hypoplasia of the internal carotid artery (ICA) is a rare congenital anomaly that is mostly unilateral and highly associated with other intracranial vascular anomalies, of which saccular aneurysm is the most common. Blood flow to the circulation of the affected side is maintained by collateral pathways, some of which include the anterior communicating artery (Acom) as part of their anatomy. Therefore, temporary clipping during microsurgery on Acom aneurysms in patients with unilateral ICA anomalies could jeopardize these collaterals and place the patient at risk of ischemic damage. In this paper, we review the literature on cases with a unilaterally absent ICA associa
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Abstract
Background: The novel coronavirus 2 (SARS?CoV?2) pandemic is a pulmonary disease, which leads to cardiac, hematologic, and renal complications. Anticoagulants are used for COVID-19 infected patients because the infection increases the risk of thrombosis. The world health organization (WHO), recommend prophylaxis dose of anticoagulants: (Enoxaparin or unfractionated Heparin for hospitalized patients with COVID-19 disease. This has created an urgent need to identify effective medications for COVID-19 prevention and treatment. The value of COVID-19 treatments is affected by cost-effectiveness analysis (CEA) to inform relative value and how to best maximize social welfare through eviden
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