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.
<p>Photovoltaic (PV) systems are becoming increasingly popular; however, arc faults on the direct current (DC) side are becoming more widespread as a result of the effects of aging as well as the trend toward higher DC voltage levels, posing severe risk to human safety and system stability. The parallel arc faults present higher level of current as compared with the series arc faults, making it more difficult to spot the series arc. In this paper and for the aim of condition monitoring, the features of a DC series arc fault are analyzed by analysing the arc features, performing model’s simulation in PSCAD, and carrying out experimental studies. Various arc models are simulated and investigated; for low current arcs, the heur
... 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, magne
... Show MoreZiziphora persica Bunge is recorded as a new Study in Iraq. This species has been collected from Jabal Sinjar in Nineveh province in the north western part of Iraq. The morphological characters, habitat and geographical distribution of the species with a key to Ziziphora L. species in Iraq have been provided.
A new series polymers was synthesized from reaction starting material Bisacodyl A or [(2-Pyridinylmethylene) di-4, 1-phenylene di acetate] with hydrogen bromide, then the products were polymerized by addition polymerization from used adipoyl and glutaroyl chloride. The structure of these compounds was characterized by FT-IR, melting points, TLC, X-Ray, DSC and 1H-NMR for starting material. These compounds were also screened for their antibacterial activists?
Background: Diabetic cheiroarthropathy is a term derived from the Greek word “cheiros” meaning “of the hand”, It is characterized by stiff hands with distinctively thick, tight, and waxy skin, especially on the dorsal aspects of the hands. It is part of long term complication of diabetes and many suggest it is associated with microvascular complication. The aim of the study was to determine the prevalence of diabetic cheiroarthropathy in Iraqi patients with diabetes, and to study its association with diabetic retinopathy and glycemic control. Material and Methods: A cross-sectional study in which 110 diabetic patients and 110 non-diabetic healthy people who accepted to take part in the study were ran
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Controls Scanning on the slippers a study fiqhiat Comparison
The subject of this research is an important topic, which is frequently repeated, and people need to know its wisdom, and has made it in front and the preface and three detectives, showed through discussion the meaning of the survey on the socks, its wisdom, its rules and conditions, and the duration of the survey on it, spoiled and reasoned and compared to the doctrinal doctrines, And the most correct statement of words I have concluded with a number of things, as follows:
- The need to ensure that the slippers are clean, visible and inwa
Transport is a problem and one of the most important mathematical methods that help in making the right decision for the transfer of goods from sources of supply to demand centers and the lowest possible costs, In this research, the mathematical model of the three-dimensional transport problem in which the transport of goods is not homogeneous was constructed. The simplex programming method was used to solve the problem of transporting the three food products (rice, oil, paste) from warehouses to the student areas in Baghdad, This model proved its efficiency in reducing the total transport costs of the three products. After the model was solved in (Winqsb) program, the results showed that the total cost of transportation is (269,
... Show MoreWhen scheduling rules become incapable to tackle the presence of a variety of unexpected disruptions frequently occurred in manufacturing systems, it is necessary to develop a reactive schedule which can absorb the effects of such disruptions. Such responding requires efficient strategies, policies, and methods to controlling production & maintaining high shop performance. This can be achieved through rescheduling task which defined as an essential operating function to efficiently tackle and response to uncertainties and unexpected events. The framework proposed in this study consists of rescheduling approaches, strategies, policies, and techniques, which represents a guideline for most manufacturing companies operatin
... Show MoreThe developments in forensic DNA technology have led us to perform this study in Iraqi population as reference database of autosomal Short Tandem Repeat (aSTR) DNA markers . A total of 120 unrelated individuals from Wasit province were analyzed at 15 STR DNA markers. Allele frequencies of DNA typing loci included in the AmpFlSTR1 IdentifilerTM PCR Amplification Kit panel from Applied Biosystems (D3S1358, vWA, FGA, D8S1179, D21S11, D18S51, D5S818, D13S317, D7S820, TH01, TPOX, CSF1PO, D19S433, D2S1338, D16S539) and several forensic efficiency statistical parameters were estimated from all the sample. the combined Matching Probability (CMP) using the 15 STR genetic loci in Iraqi population was estimated at 1 in 2.08286E-18 and the Combined
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