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.
Researching the effects of the research and technological development contract, determining its extent and demarcating the boundaries of the obligations imposed in it, is the cornerstone of economic growth and development, because defining these obligations removes the ambiguity and conflict between interests, by stating the rights owed to each party and even trying to reconcile them, or impose protection by specifying guarantees that are compatible with the essence of the R&D contract, For the purpose of studying the subject thoroughly, we will divide this research into two sections. The first is devoted to identifying the parties to the research and technological development contract. As for the other topic, we will explain the obligation
... Show MoreMany approaches have been developed over time to counter the bioavailability limitations of poorly soluble drugs. With advances in nanotechnology in recent decades, this issue has been approached through the formulation of drugs as nanocrystals. Nanocrystals consist of pure drug(s) and a minimum of surface active agent(s) required for stabilization. They are carrier-free submicron colloidal drug delivery systems with a mean particle size typically in the range of 200 - 500 nm. By reducing particle size to nanoscale, the surface area available for dissolution is increased, and thus bioavailability is enhanced. Drug nanocrystals constitute a versatile formulation approach to enhance the pharmacokinetic and pharmacodynamic properties of poorly
... Show MoreIn this research the a-As flims have been prepared by thermal evaporation with thickness 250 nm and rata of deposition r_d(1.04nm/sec) as function to annealing temperature (373 and 473K), from XRD analysis we can see that the degree of crystalline increase with T_a, and I-V characteristic for dark and illumination shows that forward bias current varieties approximately exponentially with voltage bias. Also we found that the quality factor and saturation current dependence on annealing temperatures.
Planning of cities show great attention on streets planning as one of the most structural component foundations for cities, that providing many functional needs and connect parts of the city each other, and work as a commercial and services activities centers. Instead of this highly focused on distributing streets with different streets types such as economical and trading and housing streets. This concerned was only on the dimensions and scales of different types of vehicles and their movement. When scale and dimension and movement of mans were as a second priority in designing and planning streets. Which came's first for traditional streets. The research try to submit some designs guides for planners that contribute in re conce
... Show MoreTraditionally, style is defined as the expressive, emotive or aesthetic emphasis added linguistically to the discourse with its meaning is the same. In the current study, however, style is defined as the linguistic choice that the language users can make for specific purposes.
This study, thus, aims at analyzing political Arabic and English speeches to find out whether there are differences of style between English and Arabic and whether the choices the language users make can show any traits of their psychological status.
To fulfill the above aims, the study hypothesizes that English and Arabic speeches can be analyzed stylistically and that there are stylistic difference
... Show MoreBackground : Hyperglycosylated hCG a newly discovered variant of hCG which can be used as a predictor of invasion of trophoblastic cells in patient with gestational trophoblastic disease. Objectives : To measure hyperglycosylated human chorionic gonadotrophin and to assess how far it can be used as predictor of invasion in invasive mole and choriocarcinoma. Study design control study. Setting: : Case Gynecological department in Baghdad Teaching Hospital from January 2016 to January 2017. Patient and Methods : 60 women were enrolled in this study 30 of them were with gestational trophoblastic disease (no.= 30 ) the remainder were normal pregnancy (no. =30) , hCG –H level was measured in both groups. Results : Mean serum hCG-H le
... Show MoreThe present study is a qualitative study that aims to investigate the way the Iraqi caricaturist,Dheaa Al-Hajjar uses caricatures to produce a satirical meaning humorously.Producing satire while at the same maintaining humor requires a creative thinking on the part of the caricaturist. Thus, the study examines the production of humorous satire in terms of creativity. The analysis is done from the cognitive linguistic point of view using Arthur Koestler's theory of bisociation as presented in his book The Act of Creation in 1964. The main principle on which the theory is based is that humor is created via linking (or bisociating in Koestler's terms) two habitually incompatible trains of thought in order to come up with a novel me
... Show Morepatterns of utterance stress in discourse direct attention to specific themes and reactions, controlling the flow and coherence of conversation. this study examines the utterance stress in Steve Harvey's selected episodes from a phono-stylistic perspective. this study is hoped to improve understanding of linguistic mechanism in talk show communication, highlighting the importance of phonetic features in transmitting meaning and increasing broadcast conversation participation. the researcher concentrates on the types of focus functions of utterance stress of some episodes available on YouTube. to conduct the analysis, the researcher adopts (Carr, 2013; Davenport& Hannahs 2005) to analyze utterance stress and Leech and Short (2007
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