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.
This study deals with the subject of violence, but from another perspective, it has not been emphasized in contemporary studies of violence in Arabic and raqi universities, which is the structural or institutional aspect of violence. Traditional studies have focused their analysis of violence on the direct side the violence, The other side of the violence is the hidden violence, which is characterized by a lack of clarity of the underlying factors and its effects are not arises, which makes it the most serious violence, which requires a deep research into the social, political, economic, cultural and psychological structure of society (individuals and institutions). This study was based on the theory of the Norwegian scientist (J
... Show MoreIn this paper, a new form of 2D-plane curves is produced and graphically studied. The name of my daughter "Noor" has been given to this curve; therefore, Noor term describes this curve whenever it is used in this paper. This curve is a form of these opened curves as it extends in the infinity along both sides from the origin point. The curve is designed by a circle/ ellipse which are drawing curvatures that tangent at the origin point, where its circumference is passed through the (0,2a). By sharing two vertical lined points of both the circle diameter and the major axis of the ellipse, the parametric equation is derived. In this paper, a set of various cases of Noor curve are graphically studied by two curvature cases;
... Show MoreMany cities suffer from the large spread of slums, especially the cities of the Middle East. The purpose of the paper is to study the reality of informal housing in Al-Barrakia and the most important problems that it suffers from. The paper also seeks to study the presence or absence of a correlation between urban safety indicators and urban containment indicators as one of the methods of developing and planning cities. This can be achieved through sustainable urban management. The slums are a source of many urban problems that threaten the security and safety of the residents and represent a focus for the concentration of crimes and drugs. The paper seeks to answer the following question: How can urban safety be improved through urban cont
... Show MoreThe formula is effective in Surat Nisa
(A study of gramophone)
in the name of o Allah the Merciful
Praise be to Allah, Lord of the Worlds, and prayers and peace be upon the Seal of the Prophets and Messengers. The envoy is a mercy to the worlds Muhammad Sadiq Al - Amin and to the pure and good companions of the Tayyibites.
The formula of the morphological formulas, which have diverged from other meanings, whether lexicon or contextual and what this formula contains many meanings (effective source) and (effective in the sense of effective) and (effective sense reactor) and (effective sense) and ( (F) in the sense of a similar character) and ((the name of the) (collect). This was dealt with in the formula in Surat al-Nisaa
The researcher studies and explains the content of some pictures that are published in al-Mada newspaper. The research is important as it deals with a topic that has a relation with visual culture and its role to transfer the press letter to the audience. The researcher finds that cartoonist exposed the security services through important people who have a major role in state policy and reveals the level of corruption and the weak treatments for this phenomenon and its reflection on the whole society and individuals. In addition to that, cartoonists try to encourage the public for going on the peaceful demonstrations since it is a good tool to make pressure on the government to punish the corrupts.
المستخلص [English] Peace-building is a science that has its foundations and needs mechanisms, components, studies and plans based on the needs of the parties responsible for achieving peace and meeting the necessary needs of conflict societies, as it has become a goal sought by many local and regional actors and parties. The State of South Africa has realized this fact and has devoted space in its conception and planning to addressing the issues of conflict and war within the framework of its unitary work.Since security and stability in general seek to create peaceful and legal means through which existing problems can be expressed and addressed. The differences have varied to build peace and create cooperation between groups and th
... Show MoreInterface bonding between asphalt layers has been a topic of international investigation over the last thirty years. In this condition, a number of researchers have made their own techniques and used them to examine the characteristics of pavement interfaces. It is obvious that test findings won't always be comparable to the lack of a globally standard methodology for interface bonding. Also, several kinds of research have shown that factors like temperature, loading conditions, materials, and others have an impact on surface qualities. This study aims to solve this problem by thoroughly investigating interface bond testing that might serve as a basis for a uniform strategy. First, a general explanation of how
... Show MoreInterface bonding between asphalt layers has been a topic of international investigation over the last thirty years. In this condition, a number of researchers have made their own techniques and used them to examine the characteristics of pavement interfaces. It is obvious that test findings won't always be comparable to the lack of a globally standard methodology for interface bonding. Also, several kinds of research have shown that factors like temperature, loading conditions, materials, and others have an impact on surface qualities. This study aims to solve this problem by thoroughly investigating interface bond testing that might serve as a basis for a uniform strategy. First, a general explanation of how the bonding strength
... Show MoreObjective: The aim of this study is to find out the impact of life events upon onset of depression, to describe the
prevalence of life events among depressed patients.
Methodology: Retrospective a case-control study conducted in AL-Diwanyia Teaching Hospital, Psychiatric
Department on A non-probability (purposive sample) of (60) depressed patients and (60) of healthy person were matched
with them from general population. The data were collected through the use of semi-structured interview by
questionnaire, which consists of two parts (1) divide, section A. cover letter and B. Sociodemographic data which consists
of 9-items, (2) Life events questionnaire consists of 51-items distributed to six dimensions include, family