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.
Human Interactive Proofs (HIPs) are automatic inverse Turing tests, which are intended to differentiate between people and malicious computer programs. The mission of making good HIP system is a challenging issue, since the resultant HIP must be secure against attacks and in the same time it must be practical for humans. Text-based HIPs is one of the most popular HIPs types. It exploits the capability of humans to recite text images more than Optical Character Recognition (OCR), but the current text-based HIPs are not well-matched with rapid development of computer vision techniques, since they are either vey simply passed or very hard to resolve, thus this motivate that
... Show MoreAbstract The research investigates in detail the fascinating story of its title character, which may work as an allegory for Africa itself in its past. Ama Ata Aidoo is miscellaneous writers who wrote in different literary genre like drama , short stories novel and , poetry and criticism . She is also an active feminist. Aidoo is against the colonial practice and its influence on African minds. Aidoo's play Anowa confronts painful issues in Africa's past, mostly those of the slave trade. She goes further to tackle issues of patriarchal domination and African feminism, like the relationships between individuals and society, women and motherhood, men and women, husbands and wives, mothers and daughters, and above all the future invasion
... Show MoreThis study includes a detailed morphological description of Cosmina baghdadensis sp. nov.
from Iraq.
Many characters are used in identification especially chaetotaxy and male genetalia.
Locality, host plant, and data of collection were given.
The migration from IPv4 to IPv6 can not be achieved in a brief period, thus both protocols co-exist at certain years. IETF Next Generation Transition Working Group (NGtrans) developed IPv4/IPv6 transition mechanisms. Since Iraq infrastructure, including universities, companies and institutions still use IPv4 protocol only. This research article tries to highlight, discuss a required transition roadmap and extend the local knowledge and practice on IPv6. Also, it introduces a prototype model using Packet tracer (network simulator) deployed for the design and implementation of IPv6 migration. Finally, it compares and evaluates the performance of IPv6, IPv4 and dual stack using OPNET based on QoS metrics such as throughput, delay and point to
... Show MoreHarold Pinter’s The Caretaker(1959) clearly portrays a lack of communication among the characters of the play which refers to the condition of modern man. This failure of communication led Harold Pinter to use a lot of pauses and silences in all the plays he wrote instead of words. Samuel Beckett preceded Pinter in doing so in his plays and one way to express the bewilderment of modern man during the 20th century is through the use of no language in the dramatic works. Language is no more important to modern man; instead, he uses silence to express his feelings. Silence is more powerful than the words themselves. That’s why long and short pauses can be seen throughout all Pinter’s plays.
In this play, th
... Show MoreThe research is concerned with studying the characteristics of Sustainable Architecture and Green Architecture, as a general research methodology related to the specific field of architecture, based on the differentiation between two generic concepts, Sustainability and Greening, to form the framework of the research specific methodology, where both concepts seem to be extremely overlapping for research centers, individuals, and relevant organizations. In this regard, the research tend towards searching their characteristics and to clearly differentiates between the two terms, particularly in architecture, where the research seeks understanding sustainable and green architectures, how they are so close or so far, and the
... Show MoreThis paper presents the intricate issues and strategies related to the translation of children's books, and it particularly focuses on the comparative analysis of "The Tale of Peter Rabbit" by Beatrix Potter and "Le Petit Prince" (The Little Prince) by Antoine de Saint-Exupéry. The study finds that the typical problems in translation are, idiomatic expressions, cultural reference, and the voice preservation, along side-sheet-specific challenges which each of the text faces. The translator of Potter's work should have skills of transposing all culturally oriented peculiarities of the UK land to the international audience to keep it accessible. On the contrary, "Le Petit Prince" translation will be the process of capturing the abstra
... Show MoreNanocomposites of polymer material based on CdS as filler
material and poly methyl methacrylate (PMMA) as host matrix have
been fabricated by chemical spray pyrolysis method on glass
substrate. CdS particles synthesized by co-precipitation route using
cadimium chloride and thioacetamide as starting materials and
ammonium hydroxide as precipitating agent. The structure is
examined by X-ray diffraction (XRD), the resultant film has
amorphous structure. The optical energy gap is found to be (4.5,
4.06) eV before and after CdS addition, respectively. Electrical
activation energy for CdS/PMMA has two regions with values of
0.079 and 0.433 eV.