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.
Many letters and theses written on the subject of consensus, as well as in measurement,
But we tried to address a topic of consensus
Building a blind measuring guide.
We have tried to explain the meaning of convening, then the statement of consensus in language and terminology and then the statement of measurement
Also, we have shown the types of consensus mentioned by the jurists, and this is how much was in the first topic, either
The second section included the statement of the doctrines of the blind in the matter, and then the evidence of each doctrine and discussed.
We followed it with the most correct opinion statement and concluded the research with some of the conclusions we reached through
search.
The research topics important topic of jurisprudence worship, a ruling Zakat ornaments
prepared for use, and touched the odds scholars in it. Stroll scholars say that there is no Zakat
on ornaments prepared for use have reported their evidence they and the owners say the other
of those who say should be directed to pay zakaat, and discuss those views and statement
Dafeeha of Sahihaa, and came up with a summary then, showed where the prevailing view
that I see in agreement of the transferee and reasonable. Ask Him to show us the right, and
thank God.
The Iraqi culture faced a set of challenges that can be diagnosed with the most prominent features as follows:
- The dominance of authoritarian political systems which entails authoritarian regimes with the absence of contemporary political concepts of human rights.
- The prevalence of non- informed cultural systems which have the shortage of capabilities that enable them to activate cultural elements in positive references, historical, or seclusion on itself and not be able to interact with the current active cultures.
- Stagnant economic conditions have not had a decent life for individuals, or a certain level of well-being, as well as poor services and others.
- Social life controlled by the prevai
The research aims to know the traits or characteristics of woman in terms of her external
appearance, motives for her behavior, feelings, mood and ability.
It, moreover, seeks woman’s relationship with others as it is presented by the Iraqi
satirical television show “ State of Melon “.
The researcher adopted for that survey approach using the method of content analysis
to study the research sample represented by “ State of Melon “ show which was
exposed through the screen of a group of channels:
“Hona Baghdad Satellite Channel, then Asia Satellite Channel, Dijla Satellite Channel,
and UTV Satellite Channel.”For this, the researcher used Margaret Gallagher’s Model to analyze the image of
woman in
(1)
Somerset Maugham is known mainly as a novelist . This paper presents Maugham the dramatist . Many critics have found him a promising dramatist . He has written 30 plays , then he turns his back upon the theater and writes his autobiographical and most successful novel Of Human Bondage ( 1915) .
Maugham's writing is clear , precise , and simple . He is described as a realist who is keenly aware of human nature , its concentration and frustration . His only tragedy A Man of Honour is a play in 4 acts . This paper concentrates mainly on this play to show Maugham as a dramatist and to show his concept of " honour " .
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... Show MoreIn this paper, a numerical model for fluid-structure interaction (FSI) analysis is developed for investigating the aeroelastic response of a single wind turbine blade. The Blade Element Momentum (BEM) theory was adopted to calculate the aerodynamic forces considering the effects of wind shear and tower shadow. The wind turbine blade was modeled as a rotating cantilever beam discretized using Finite Element Method (FEM) to analyze the deformation and vibration of the blade. The aeroelastic response of the blade was obtained by coupling these aerodynamic and structural models using a coupled BEM-FEM program written in MATLAB. The governing FSI equations of motion are iteratively calculated at each time step, through exchanging data between
... Show MoreModeling the microclimate of a greenhouse located in Baghdad under its weather conditions to calculate the heating and cooling loads by computer simulation. Solar collectors with a V-corrugated absorber plate and an auxiliary heat source were used as a heating system. A rotary silica gel desiccant dehumidifier, a sensible heat exchanger, and an evaporative cooler were added to the collectors to form an open-cycle solar assisted desiccant cooling system. A dynamic model was adopted to predict the inside air and the soil surface temperatures of the greenhouse. These temperatures are used to predict the greenhouse heating and cooling loads through an energy balance method which takes into account the soil heat gain. This is not included in
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(3)
The goal of health awareness is to familiarize people with health information and facts, and make them realize their sense of responsibility towards their health and the health of others. And translate that goal in practice through applying healthy and sound behaviors spontaneously. This, the goal, is pursued by health awareness announcements through employing announcement persuasion of health as one of the methods of influencing the masses to adopt ideas, behaviors, and adherence to health advice and guidelines; The study aims to analyze the content of the Ministry of Health and Environment announcements regarding health awareness and to reveal the most employable persuasions in health awareness announcements
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Acne vulgaris is a very common, chronic disorder, involving inflammation of the pilosebaceous units that can be varied in presentation and difficult to treat. Inflammatory acne may yield both scarring and pigmentary changes so early and adequate therapy will, in all cases, decrease its severity and may entirely suppress this disease. Serratiopeptidase has anti-inflammatory, anti-edemic and fibrinolytic activity and acts rapidly on localized inflammation. Serratiopeptidase was added in aim to hasten acne resolution. During March to July 2010, A comparative study for a 50 healthy patient suffering from acne was divided into 2 groups: 1st group treated by common acne modalities and the 2nd one with same modalities
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