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.
Effects of Ozonated Water on Micro Leakage between Enamel and Fissure Sealants Prepared by Different Etching Technique (An in vitro Study), Baraa M Jabar*, Muna S Khalaf
The development of Japanese society passed through long historical stages and as a result of the bitter experience of Japan in the Second World War and its exhaustion, it was able to build a modern modern state after 1945. Japan is a country of culture, civilization, science and technology, a country that appreciates the value of solidarity work. And the role of active civil society. This is what makes us in Iraq stand and draw their experience in the advancement and development, especially that they also passed bitter political stages, Iraq today passes through the most historical periods of forestry through its historical heritage in terms of the existence of complex social problems, the US occupation of Iraq in 2003 highlighte
... Show MoreObjective(s): To assess the behavior that impedes the eating of children with autism spectrum disorders in Baghdad city, and find out the relationships between the behaviors that impede eating of autistic children and their demographic characteristics.
Methodology: The study started from the period of 16th September 2019 to the 16th of March 2020. A non-probability (purposive) sample of 80 children with autism spectrum disorders was selected. The questionnaire was designed and composed of two parts: the first part includes the autistic children demographic data, the second part includes scales of behavior that impede eating followed by parents towards autistic child. The reliability of the questionnaire was determined through a pilot
Abstract
The current research aims to identify the role of family upbringing methods in shaping adolescent gender identity disorder, to identify the causes, components, and disorders of the gender identity of adolescents, and to develop practical visions and suggestions to reduce and stop gender identity disorder completely. Due to the sensitivity of the topic, a questionnaire of five open-ended questions was posted on Facebook to collect the needed data, where (20) respondents answered these questions. The researcher took these (20) respondents as the study sample. The results revealed that excessive emancipation within the family, failure to employ family protection laws, and failure to monitor and follow up on
... Show MoreIn recent decades, drug modification is no longer unusual in the pharmaceutical world as living things are evolving in response to environmental changes. A non-steroidal anti-inflammatory drug (NSAID) such as aspirin is a common over-the-counter drug that can be purchased without medical prescription. Aspirin can inhibit the synthesis of prostaglandin by blocking the cyclooxygenase (COX) which contributes to its properties such as anti-inflammatory, antipyretic, antiplatelet and etc. It is also being considered as a chemopreventive agent due to its antithrombotic actions through the COX’s inhibition. However, the prolonged use of aspirin can cause heartburn, ulceration, and gastro-toxicity in children and adults. This review article hi
... Show MoreThe investigative film is part of the documentary films and is considered one of the important films that have a high viewership by the recipient, which is of great importance in transmitting information and contributing to creating awareness of the community through the advertising function performed by the cinematic image, as the researcher addresses the concept of advertising and its development through the time stages. And advertising functions. Then the researcher dealt in his research with the cinematic technical elements that contribute to the success of the investigative advertising work, such as camera movements, music, sound effects, dialogue ... etc., which enrich the investigative picture with realism and the flow of informat
... Show MoreArchitecture has evolved through the ages as forms, relationships, materials and mechanisms according to the data of each era and up to the era of digital technology, where the change in proportions and aesthetic dimensions of contemporary architectural formation due to the capabilities of digitization has created innovative plastic properties using the void formation in the facades and the introduction of void as a formative and aesthetic element, which led to The emergence of new creative concepts and ideas that contradict traditional ideas and are consistent with the spirit of the times, led to a revolution in the world of architectural form at the level of (architectural ideas and the generation of shapes, materials and construction
... Show MoreWith 549,393 new cases recorded in 2018, bladder cancer is one of the most common malignancies worldwide. Urinary bladder cancer is the cause of about 3 percent of all new cancer diagnoses and 2.1 percent of all cancer deaths. This study aims to evaluate the efficiency of the N-myc downstream-regulated gene 1(NDRG1) as a biomarker for bladder cancer patients in the Iraqi population. One hundred individuals in the case-control study were enrolled and divided into two groups. The first group included 50 patients diagnosed with a bladder mass and investigated by undergoing cystoscopy examination for transurethral resection of bladder tumor (TURB). The second group included 50 healthy individuals who had normal bladder tissue. The resul
... Show MoreGaines's A Lesson Before Dying (1993) is about more than the challenges associated with being blacking an Eurocentric society. Though Gaines positions the story within the context of the African American experience, its central theme investigates what it means to be human. The Afro-American writer Ernest Gaines consistently writes about people who face the problems of being denied humanity, dignity, and self-worth. The article illustrates one man's struggle to gain recognition of his humanity in the court (as his attorney insists on calling him a hog for a crime he did not commit) and how this recognition will initiate a change in the community.