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.
Sustainability is a major demand and need pursued by cities in all areas of life due to the environmental, social and economic gains they provide, especially in the field of city planning and urban renewal projects that aim to integrate the past, present and future.
The research aims to evaluate the Haifa Street renewal project, and Al-Shawaka district, one of the Baghdad districts located next to Al-Karkh, was elected by comparing the sustainability indicators of urban renewal with the reality of the situation through a field survey and questionnaire form and focusing on the social and economic impacts and environmental for the project on the study area. To reach the most important conclusions and recommendations
... Show MoreBackground: Radiopacity is one of the prerequisites for dental materials, especially for composite restorations. It's essential for easy detection of secondary dental caries as well as observation of the radiographic interface between the materials and tooth structure. The aim of this study to assess the difference in radiopacity of different resin composites using a digital x-ray system. Materials and methods: Ten specimens (6mm diameter and 1mm thickness) of three types of composite resins (Evetric, Estelite Sigma Quick,and G-aenial) were fabricated using Teflon mold. The radiopacity was assessed using dental radiography equipment in combination with a phosphor plate digital system and a grey scale value aluminum step wedge with thickness
... Show MoreBackground Molluscum contagiosum is skin disease caused by the molluscum contagiosum virus (MCV) usually causing one or more small dome shaped umbilicated papules with symptoms that maybe self-resolve. MCV was once a disease primarily of children, but it has evolved to become a sexually transmitted disease in adults. It is believed to be a member of the pox virus family. In addition to the classic presentation of the disease; it can also come in different clinical forms that simulate large number of dermatolological disease.
Objective: To study different clinical forms of Molluscum contagiosum presentation in different age groups of Iraqi patients.
Method:This clinical descriptive study was performed in the outpatient department of
The objective of this article is to delve into the intricate dynamics of marriage relationships, exploring the impact of emotions such as fear, love, financial considerations and likability. In our investigation, we adopt a perspective that acknowledges the nonlinear nature of interactions among individuals. Diverging from certain prior studies, we propose that the fear element within the context of marriage is not a singular, isolated factor but rather a manifestation resulting from the amalgamation of numerous social issues. This, in turn, contributes to the emergence of strained and unsuccessful relationships. Unlike conventional approaches, we extensively examine the conditions essential for the existence of all socially signifi
... Show MoreThe Cu(II) was found using a quick and uncomplicated procedure that involved reacting it with a freshly synthesized ligand to create an orange complex that had an absorbance peak of 481.5 nm in an acidic solution. The best conditions for the formation of the complex were studied from the concentration of the ligand, medium, the eff ect of the addition sequence, the eff ect of temperature, and the time of complex formation. The results obtained are scatter plot extending from 0.1–9 ppm and a linear range from 0.1–7 ppm. Relative standard deviation (RSD%) for n = 8 is less than 0.5, recovery % (R%) within acceptable values, correlation coeffi cient (r) equal 0.9986, coeffi cient of determination (r2) equal to 0.9973, and percentage capita
... Show MoreTrajectory tracking and vibration suppression are essential objectives in a flexible joint manipulator control. The flexible joint manipulator is an under-actuated system, in which the number of control actions is less than the degree of freedom to be controlled. It is very challenging to control the underactuated nonlinear system with two degree of freedom. This paper presents a hierarchical sliding mode control (HSMC) for a rotary flexible joint manipulator (RFJM). Firstly, the rotary flexible joint manipulator is modeled by two subsystems. Secondly, the sliding surfaces for both subsystems are constructed. Finally, the control action is designed based on the Lyapunov function. Computer simulation results demonstrate the effectiveness of
... Show MoreObjective Thalassemic patients present with multiple immune abnormalities that may predispose them to oral Candida, however this has not been investigated. The aim of this study was to assess oral candidal colonization in a group of patients with β-thalassemia major both qualitatively and quantitatively. Study design The oral mycologic flora of 50 β-thalassemia major patients and 50 age- and sex-matched control subjects was assessed using the concentrated oral rinse technique. Candida species were identified using the germ tube test and the Vitek yeast identification system. Results Oral Candida was isolated from 37 patients (74%) and 28 healthy subjects (56%; P = .04). The mean candidal count was significantly higher in thalassemic patie
... Show MoreSoil water retention curves (SWRCs) are crucial for characterizing soil moisture dynamics and are particularly relevant in the context of irrigation management. A study was carried out to obtain the SWRC, inflection point, S index, pore size distribution curve, macro porosity, and air capacity from samples submitted to saturation and re-saturation processes. Five different-texture disturbed soil samples Sandy Loam, Loam, Sandy Clay Loam, Silt Loam, and Clay were collected. After obtaining SWRC, each air-dried soil samples were submitted to particle size distribution and clay dispersed in water analyses to verify the soil lost clay. The experimental design was completely randomized with three replications using two processes of SWRC (saturat
... Show MoreChoosing antimicrobials is a common dilemma when the expected rate of bacterial resistance is high. The observed resistance values in unequal groups of isolates tested for different antimicrobials can be misleading. This can affect the decision to recommend one antibiotic over the other. We analyzed recalled data with the statistical consideration of unequal sample groups. Data was collected concerning children suspected to have typhoid fever at Al Alwyia Pediatric Teaching Hospital in Baghdad, Iraq. The study period extended from September 2021 to September 2022. A novel algorithm was developed to compare the drug sensitivity among unequal numbers of Salmonella typhi (S. Typhi) isolates tested with different antibacterials.
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