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.
Abstract
This research aims to design a multi-objective mathematical model to assess the project quality based on three criteria: time, cost and performance. This model has been applied in one of the major projects formations of the Saad Public Company which enables to completion the project on time at an additional cost that would be within the estimated budget with a satisfactory level of the performance which match with consumer requirements. The problem of research is to ensure that the project is completed with the required quality Is subject to constraints, such as time, cost and performance, so this requires prioritizing multiple goals. The project
... Show MoreIntroduction: Diabetic foot infections are one of the most severe complications of diabetes. This study was aimed to determine the common bacterial isolates of diabetic foot infections and the in vitro antibiotic susceptibility then treatment.
Methods: A swab was taken from the foot ulcer, and the aerobic bacteria were isolated and identified by cultural, microscopic and biochemical test, then by api-20E system. After that their antibiotic susceptibility pattern was determined. Then local and systemic treatment was used to treat the diabetic foot patients.
Results: Bacterial isolates belonging to twelve species were obtained from diabetic foot patients. Gram (-) bacteria were the predominant pathogens in the diabetic foot infection
Constructing a fine 3D geomodel for complex giant reservoir is a crucial task for hydrocarbon volume assessment and guiding for optimal development. The case under study is Mishrif reservoir of Halfaya oil field, which is an Iraqi giant carbonate reservoir. Mishrif mainly consists of limestone rocks which belong to Late Cenomanian age. The average gross thickness of formation is about 400m. In this paper, a high-resolution 3D geological model has been built using Petrel software that can be utilized as input for dynamic simulation. The model is constructed based on geological, geophysical, pertophysical and engineering data from about 60 available wells to characterize the structural, stratigraphic, and properties distri
... Show MoreThe issue of the research lies in the non-representation of the models developed for the communication process in the interaction and networking processes through social media, as the research sought to build a network model of communication according to the specific data and features of social media platforms in order to reach a special generalization to understand how the process of networking operates in cyberspace.
The researcher followed the analytical survey approach as she described the communication models outwardly in order to be able to build a networked communication model that represents the flow of post-reactive communication. Therefore, it has been named "Nebula - Sadeem" after the concept of post-space and cosmic g
... Show MoreInformation pollution is regarded as a big problem facing journalists working in the editing section, whereby journalistic materials face such pollution through their way across the editing pyramid. This research is an attempt to define the concept of journalistic information pollution, and what are the causes and sources of this pollution. The research applied the descriptive research method to achieve its objectives. A questionnaire was used to collect data. The findings indicate that journalists are aware of the existence of information pollution in journalism, and this pollution has its causes and resources.
The purpose of this research is to find the estimator of the average proportion of defectives based on attribute samples. That have been curtailed either with rejection of a lot finding the kth defective or with acceptance on finding the kth non defective.
The MLE (Maximum likelihood estimator) is derived. And also the ASN in Single Curtailed Sampling has been derived and we obtain a simplified Formula All the Notations needed are explained.
Rudimentary non-communicating functional uterine horn with unicornuate uterus, originating from anomalous embryological development of one Mullerian duct, is prone to different complications either at the gynecological or obstetrical level such as chronic pelvic pain, hematometra, subfertility and decreased quality of life. This unique case report presents a 14-year-old female with a history of severe chronic pelvic pain. She was diagnosed with Familial Mediterranean Fever (FMF) and had an appendectomy for suspected appendicitis within the symptoms’ interval. Ultrasound showed a right 5*6 cm right complex cystic mass assuming ovarian in place. She underwent a suspected endometrioma cystectomy operation and was diagnosed with left unico
... Show MoreA study on solvent extraction of Tellurium with Anthranilic acid in
water has been made. The effect of different parameters such as type of medium, time of equilibration, concentration of metal ion, solvent polarity and effect of anions and catins distribution ratio of tellrim (IV) were evaluated. The stoichometric ratio of the extracted species is determined by using two methods suh as slope analysis and mole ratio method and found to be (M: L) (1:4). The instability constant of complex was calculated as well.
Seeking pharmacist advice about minor ailments is a common practice among Iraqi patients because such advice is free and quick. Unfortunately, the assessment and management of minor ailments by Iraqi pharmacists were inappropriate. Therefore, this study aimed to develop a model for a mobile application that can assist community pharmacists in the diagnosis and management of minor ailments.
The scientific content of the application was based on the information in the symptoms in the pharmacy and British Nati