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 surgery Keywords: Non-surgical treatment of anal fissure, fissure in ano, sphicterotomy,botulinum toxin in anal fissures, glyceryl trinitrate. Chemical sphincteratomy, pharmacological sphincteratomy.
Dialogue is one of the most important means of calling to the Creator, as it is one of the scientific and verbal activities carried out by a group of interlocutors to present ideas they believe in, and evidence and proofs that express their views and demonstrate the reason for their belief in them, In order to arrive at the truth or a radical solution to a specific problem, so the interlocutor should pay attention to this science, study it and its etiquette, because the purposeful dialogue requires that the funniest of them be the most knowledgeable and knowledgeable about the axis of the hadith, and the funniest must also be able to be convinced of the rule of difference of opinion that does not spoil the issue of friendly They must also c
... Show MoreThis paper presents a study for the influence of magnetohydrodynamic (MHD) on the oscillating flows of fractional Burgers’ fluid. The fractional calculus approach in the constitutive relationship model is introduced and a fractional Burgers’ model is built. The exact solution of the oscillating motions of a fractional Burgers’ fluid due to cosine and sine oscillations of an infinite flat plate are established with the help of integral transforms (Fourier sine and Laplace transforms). The expressions for the velocity field and the resulting shear stress that have been obtained, presented under integral and series form in terms of the generalized Mittag-Leffler function, satisfy all imposed initial and boundary conditions. Finall
... Show MoreThere are many varied studies that dealt with the dramatic construction, especially books and studies that addressed drama in its construction and the method of writing it, that no textbook or a general cultural content is void of tackling the dramatic text in its construction and how the dramatic action develops in it. Therefore, a question occurs to the mind about the feasibility of dealing with the dramatic construction in this time, where many contemporary studies of dramatology and its relation and the contemporary critical directions are accumulating. This question many have two realistic aspects, yet the novelty and originality that this research shows lie in addressing a refined linguistic text in its style and connotations, such
... Show MoreAccording to the circumstances experienced by our country which led to Occurrence of many crises that are the most important crisis is gaining fuel therefore , the theory of queue ( waiting line ) had been used to solve this crisis and as the relevance of this issue indirect and essential role in daily life .
This research aims to conduct a study of the distribution of gasoline station in (both sides AL – kharkh and AL Rusafa, for the purpose of reducing wasting time and services time through the criteria of the theory of queues and work to improve the efficiency of these stations by the other hand. we are working to reduce the cost of station and increase profits by reducing the active serv
... Show MoreObjective :.
1-Find out the prevalence of alcohol and drugs addiction in two different years before and after the last
war i.e. in 2002 and in 200. 2-Study the association between the addiction
and some variables. 3-Identify the prescribed drugs and other substances that
have been abused
Methodology : A retrospective study has been conducted involving the in-patients at addiction unit-IbnRushd
psychiatric hospital in Baghdad by applying the semi-structured form based on ICD-10 criteria
of addiction and dependency with the confirmation of the specialist psychiatrist diagnosis of
dependency. Data concerning each patient admitted in the hospital was gathered to have an idea about
the problem of addiction (drugs an
The coefficient of performance of a window type Air-Conditioner system can be improved if a reduction in the work of compressor can be achieved by a suitable technique. The present study investigates the effect of dispersing a low concentration of TiO2 nanoparticles in the mineral oil based lubricant, as well as on the overall performance of a window type Air-Conditioner system using R22 as the working fluid. An enhancement in the COP of the refrigeration system has been observed and the existence of an optimum volume fraction noticed, with low concentrations of nanoparticles suspended in the mineral oil. Results showed that the average compressor work reduced by 13.3%, which ultimately resulted in an increase of 11.99% in the COP due to
... Show MoreThe problem of the study and its significance:
Due to the increasing pressures of life continually, and constant quest behind materialism necessary and frustrations that confront us daily in general, the greater the emergence of a number of cases of disease organic roots psychological causing them because of severity of a lack of response to conventional treatments (drugs), and this is creating in patients a number of emotional disorders resulting from concern the risk of disease
That is interested psychologists and doctors searchin
... Show MoreThis paper proposes a new method to tune a fractional order PID controller. This method utilizes both the analytic and numeric approach to determine the controller parameters. The control design specifications that must be achieved by the control system are gain crossover frequency, phase margin, and peak magnitude at the resonant frequency, where the latter is a new design specification suggested by this paper. These specifications results in three equations in five unknown variables. Assuming that certain relations exist between two variables and discretizing one of them, a performance index can be evaluated and the optimal controller parameters that minimize this performance index are selected. As a case study, a thir
... Show MoreEconazole nitrate (EN) is considered as the most effective agent for the treatment of all forms of dermatomycosis caused by dernatophytes. It was formulated as a topical solution in our laboratories. This study was designed to evaluate the effectiveness of Econazol Nitrate in the prepared formula and compared with that of commercial brand, Pevaryl®. A total of 104 patient suffering from dermatomycoses were involved in this investigation. Both formula were applied to the affected skin region in the morning and evening from week to 16 weeks with light massage until complete healing effect was achieved. The data revealed that the percentage of cured patient treated with the prepared formula and reference formula of Ecanozol Nitrate 1% so
... Show MoreAssimilation is defined ,by many phoneticians like Schane ,Roach ,and many others, as a phonological process when there is a change of one sound into another because of neighboring sounds.This study investigates the phoneme assimilation as a phonological process in English and Arabic and it is concerned specifically with the differences and similarities in both languages. Actually ,this study reflects the different terms which are used in Arabic to refer to this phenomenon and in this way it shows whether the term 'assimilation ' can have the same meaning of 'idgham' in Arabic or not . Besides, in Arabic , this phenomenon is discussed from&nb
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