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.
OpenStreetMap (OSM), recognised for its current and readily accessible spatial database, frequently serves regions lacking precise data at the necessary granularity. Global collaboration among OSM contributors presents challenges to data quality and uniformity, exacerbated by the sheer volume of input and indistinct data annotation protocols. This study presents a methodological improvement in the spatial accuracy of OSM datasets centred over Baghdad, Iraq, utilising data derived from OSM services and satellite imagery. An analytical focus was placed on two geometric correction methods: a two-dimensional polynomial affine transformation and a two-dimensional polynomial conformal transformation. The former involves twelve coefficients for ad
... Show MoreDavid Hare (b.1947) is one of the most critically acclaimed, contemporary British dramatists. A playwright, director and filmmaker, he has written more than thirty plays for the stage and seven original screen plays for cinema and TV (Susan Emerling, p.1). He began his dramatic career in the late sixties. Along with such dramatists as Howard Brenton and Trevor Griffiths, he writes in the aftermath of the "Angry Young Men" tradition of John Osborne. It is a well-known fact that the element of anger continued in the drama of the 1960s and became even more radicalized after the social, cultural and political unrests of 1968 by the dramatists of the "second wave" to whom Hare belongs (John Russell Taylor, p.14). Setting his plays in a variet
... Show MoreThe present study aims at analyzing the polysemy of the English preposition in from the cognitive linguistic (CL) point of view using Evans' and Tyler's approach (2003). The perplexity faced by Iraqi second language learners (L2) due to the multi-usages of this preposition has motivated the researcher to conduct this study. Seventy-six second year university students participated in this experimental study. The data of the pre-test and post-test were analyzed by SPSS statistical editor. The results have shown the following: First, a progress of more than (0.05≤) has been detected as far as students' understanding of the multiple usages of the preposition in is concerned. Second, the results of the questionnaire have s
... Show MoreThe aim of the current research is to construct a scale of emotional adjustment for kindergarten children and to set a standard for its evaluation. To achieve this, a scale consisting of (19) items was prepared. The mother of the child answered by adopting the method of self-report, which is expressed in the form of reporting terms, as each item represents a situation in the child's life and each situation has three alternatives to answer that represent various responses to the mentioned situation. One of the alternatives represents the emotionally adaptive response, which is given a degree (3), the second response expresses the emotional adjustment partly that took the degree of (2), and the third response expresses the weakness of emot
... Show MoreThe sensitive and important data are increased in the last decades rapidly, since the tremendous updating of networking infrastructure and communications. to secure this data becomes necessary with increasing volume of it, to satisfy securing for data, using different cipher techniques and methods to ensure goals of security that are integrity, confidentiality, and availability. This paper presented a proposed hybrid text cryptography method to encrypt a sensitive data by using different encryption algorithms such as: Caesar, Vigenère, Affine, and multiplicative. Using this hybrid text cryptography method aims to make the encryption process more secure and effective. The hybrid text cryptography method depends on circular queue. Using circ
... Show MoreMaximizing the net present value (NPV) of oil field development is heavily dependent on optimizing well placement. The traditional approach entails the use of expert intuition to design well configurations and locations, followed by economic analysis and reservoir simulation to determine the most effective plan. However, this approach often proves inadequate due to the complexity and nonlinearity of reservoirs. In recent years, computational techniques have been developed to optimize well placement by defining decision variables (such as well coordinates), objective functions (such as NPV or cumulative oil production), and constraints. This paper presents a study on the use of genetic algorithms for well placement optimization, a ty
... Show MorePolymethylmethacrylate film (PMMA) of thickness 75 μm was evaluated Spectrophotometrically for using it as a low-doses gamma radiation dosimeter. The doses were examined in the range 0.1 mrad-10 krad. Within an absorption band of 200-400 nm, the irradiated films showed an increase in the absorption intensity with increasing the absorbed doses. Calibration curves for the changes in the absorption differences were obtained at 218, 301, and 343 nm. At 218 nm the response for the absorbed doses is a linear in the range 10 mrad- 10 krad. Hence it is recommended to be adopted as an environmental low doses dosimeter
In this research, we introduce and study the concept of fibrewise bitopological spaces. We generalize some fundamental results from fibrewise topology into fibrewise bitopological space. We also introduce the concepts of fibrewise closed bitopological spaces,(resp., open, locally sliceable and locally sectionable). We state and prove several propositions concerning with these concepts. On the other hand, we extend separation axioms of ordinary bitopology into fibrewise setting. The separation axioms we extend are called fibrewise pairwise T_0 spaces, fibrewise pairwise T_1 spaces, fibrewise pairwise R_0 spaces, fibrewise pairwise Hausdorff spaces, fibrewise pairwise functionally Hausdorff spaces, fibrewise pairwise regular spaces, fibrewise
... Show MoreBackground: Osteoid osteoma(OO) is a relatively common benign skeletal neoplasm of unknown etiology that is composed of osteoid and woven bone, usually seen in adolescent and young males Although, the clinical, radiological and scintigraphic features of OO have been well described, these features may be misleading or altered in the cases of lesser trochanter of the femur which is relatively uncommon location for OO with a few number of cases reported up to date. Case Presentation: We report a case of a 20-year-old man who presented with painful limpThe pain had begun six months earlier and was made worse by walking and by exercise., with normal initial X-rays .The diagnosis was made after six months when typical Computed tomography, magneti
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