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.
Microfinance Institutions (MFIs) offers small loans with easy repayment system and till now these institutions have served millions of needy people around the globe. This study highlights the hurdles influence the smooth working and growth of Microfinance institution in Egypt. The structured interviews were conducted from the top and mid-level managers of MFI's. This study revealed that interest rate, political and economic conditions, corruption, customer outreach, competition and technology are the important elements for MFI's success. It is evident that lack of use of technology and less importance drawn on customer outreach programs are the main challenges of MFI's in Egypt. This study provides a roadmap for practitioners and strategic
... Show MoreBackground: Sonographic examination is an important tool in assessment of normal and abnormal cervical lymph nodes. The aim of the study is to assess the distribution and the characteristic features of normal cervical lymph nodes in a sample of Syrian population. Materials and Methods: Fifty healthy Syrian subjects (25 men and 25 women) with an age of 20 -60years old, who had their cervical lymph nodes examined by ultrasound. Three hundred and two lymph nodes were detected. Lymph nodes were evaluated for their number, size, site, echogenic hilus, shape, as well as for the border sharpness. The subjects were categorized by age into four groups, (20 -30, 31 - 40 , 41 - 50 , 51- 60 years ). Statistical analysis of data was done using SP
... Show MoreShatt Al-Arab River in Al Basrah, Iraq, has recently recorded massive levels of TDS values (Total Dissolved Solids) in the water as a result of reduced fresh water discharge from sources, causing the river to become salinized due to salt wedge intrusion. Therefore, a block dam in the south reach is required to salt intrusion prevention. The main objective of this research is to simulate the hydraulic impact of a suggested barrage in Ras Al Besha on the Shatt Al-Arab River. The HEC-RAS (5.0.7) model was used to develop a one-dimensional unsteady model to gaining an understanding of the proposed barrage's influence on river behaviour. The daily discharges of the Tigris River provided as the upstream boundary conditions, wh
... Show MoreThis study analyzes how to make use of the resources in the marshlands of Iraq and how to utilize them, especially after the water returns to these areas and they are revitalized. We take an example of AL- Saheen Marsh and plan an ideal tourist resort there. This example can further expand to include other parts of the marshlands. The resort will utilize the local environment and tourist characteristics as it will have a feel and architectural resemblance to the houses and buildings that are currently built there. In addition the transportation methods will be the same as those used by the locals. Yet the resort will still posses all the facilities required by a modern tourist resort that includes all the services that will make
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The present paper attempts to detect the level of (COVID-19) pandemic panic attacks among university students, according to gender and stage variables.
To achieve this objective, the present paper adopts the scale set up by (Fathallah et al., 2021), which has been applied electronically to a previous cross-cultural sample consisting of (2285) participants from Arab countries, including Iraq. The scale includes, in its final form, (69) optional items distributed on (6) dimensions: physical symptoms (13) items, psychological and emotional symptoms (12) items, cognitive and mental symptoms (11) items, social symptoms (8) items, general symptoms (13) items and daily living practices (12) items
... Show MoreBackground: The use of electronic apex locators for working length determination eliminates many of the problems associated with the radiographic measurements (interference of anatomical structures, errors in projection such as elongation or shortening, and lack of three-dimensional representation). Its most important advantage over radiography is that it measures the length of the root canal to the apical constriction, not to the radiographic apex. The aim of this study was to assess the accuracy of a new fifth generation apex locator (Joypex 5) in recording the apical constriction and comparing it with a third generation apex locator (Root ZX) in vitro. Materials and method: Twenty four single-rooted sound human premolars, extracted for t
... Show MoreNowadays, Wheeled Mobile Robots (WMRs) have found many applications as industry, transportation, inspection, and other fields. Therefore, the trajectory tracking control of the nonholonomic wheeled mobile robots have an important problem. This work focus on the application of model-based on Fractional Order PIaDb (FOPID) controller for trajectory tracking problem. The control algorithm based on the errors in postures of mobile robot which feed to FOPID controller to generate correction signals that transport to torque for each driven wheel, and by means of dynamics model of mobile robot these torques used to compute the linear and angular speed to reach the desired pose. In this work a dynamics model of
... Show MoreThis paper presents a new algorithm in an important research field which is the semantic word similarity estimation. A new feature-based algorithm is proposed for measuring the word semantic similarity for the Arabic language. It is a highly systematic language where its words exhibit elegant and rigorous logic. The score of sematic similarity between two Arabic words is calculated as a function of their common and total taxonomical features. An Arabic knowledge source is employed for extracting the taxonomical features as a set of all concepts that subsumed the concepts containing the compared words. The previously developed Arabic word benchmark datasets are used for optimizing and evaluating the proposed algorithm. In this paper,
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