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.
Worldwide, enormous amounts of waste cause major environmental issues, including scrap tires and plastic, and large waste, a consequence of the demolition of buildings, including crushed concrete, crushed clay bricks, and crushed thermo-stone. From that point, it’s possible to consider that the recycling processes for these materials and using them in the manufacturing field will reduce the adverse effects on the environment of these wastes and the consumption of natural resources. Sustainable concrete blocks can be considered as one of the products produced by using these materials as partial volume replacement of the coarse, fine aggregate, or cement content, considering their dry density, workability, absorption, compressive st
... Show MoreConstruction projects are characterized as projects with multi phases and activities, complex, unique, and have many different parties and stakeholders. Risks could appear at one or more of the construction project stages and may affect the achievement of project objectives. Therefore, one of the key elements in the planning phase of any project is the risk management process (RMP). This study attempts to understand the terminology of risk in general, risk management, and response to risk in particular. This study is mainly a review of thirty-eight studies that have been published between 1997 and 2020 that demonstrate the importance of the crucial phase of risk response from the risk management process and its impact on
... Show MoreThis review paper examines the crucial impact of YouTube on learning English as a Foreign Language. Recently, learners’ interaction and development of their skills have been improved due to the integration of digital platforms into language education. YouTube is regarded as one of the most prevalent platforms due to its accessibility, multimodal content, and capacity to simulate real-life communication. This study tackles thirty selected research articles from various cultural and institutional backgrounds to identify the pedagogical benefits and challenges associated with using YouTube in teaching English. Conventional methods of teaching English as a foreign language encounter difficulties in improving students’ engagement and
... Show MoreBackground: Lamotrigine is a second generation Anti-epileptic drug; it is widely used for the treatment of epilepsy and bipolar disorder. Sufficient data is not available concerning its teratogenicity. Aim of the study: The study has been carried out to evaluate the effect of lamotrigine on Rat kidney development. Materials and Methods: The study was conducted on 10 pregnant Albino Rats (Rattus rattus) divided equally into two groups, control and experiment groups. Experiment group received lamotrigne 10mg/kg/day orally using naso-gastric tube from the first day of gestation until the first week after birth, while the control group received distilled water. Newborn kidneys were collected at day 7 postnatal and fixated in bouin’s solution,
... Show MoreObjective(s): To determine the prevalence of ADHD among elementary school pupils; identify the association between pupil's level of ADHD and age, etc., and investigate the differences in pupils ADHD based on gender, and grade.
Methodology: A descriptive study was conducted on elementary school pupils. The study started from the period of 16th of September 2019 to the 1st of October 2020. A cluster sample of 800 pupils was selected. The questionnaire was constructed and developed and include two parts: the first part includes the pupil's general information and the second part includes scale of ADHD prevalence.
Results: The results of the present study indicated that 38(4.
... Show MoreThese factors, as well as disasters and wars that the Arab homeland exposed to and still under this exposure, in addition to the severe stress upon.
Iraqi Academics have been subjected to direct consequences of 2003 war. Exact figures are not known. It was mentioned. Many people were killed, sacked from their academics jobs, threatened to leave directly or indirectly their jobs, houses, and Iraq. Others have been imprisoned, tortured, or kidnapped / threatened to be kidnapped etc. Their families have been subjected to similar traumatic experiences or threats. All theses stressors may have lead to Post Traumatic (PTSD) Experiences. These Traumatic experiences have lead to Dislocation, relocation and Immigration etc. All sectors of
... Show MoreThe current research aims to measure Generalized Anxiety Disorder among students of the University of Sulaymaniyah / College of Basic Education, and to identify the significance of differences between sex, scientific specialization and age, and for that reason, the research sample of (102) male and female students was chosen in a random manner, and the researcher used the diagnostic criteria for the generalized anxiety disorder contained He mentioned it in the Statistical and Diagnostic Manual of Psychiatry, and the paragraphs of the scale were formulated according to those standards after they verify the conditions of honesty and consistency, and the use of appropriate statistical means. The results of the research indicated that genera
... Show MoreSymptoms of posttraumatic stress disorder are associated with various variables such as the exposure to traumatic events, sex and age. Such events could lead to negative cognitions towards self and the world. These cognitions, in turn, may lead to traumatic related disorders.
The present study aims to identify the percentage of traumatised individuals according to sex and age category variables. It also aims to assess the average of spreading symptoms of posttraumatic stress disorder of traumatised individuals according to sex and age category variables. Likewise, it aims to test variables significance in cognitions towards the world and the self according to the level of the spread of posttraumatic stre
... Show MoreInformation hiding strategies have recently gained popularity in a variety of fields. Digital audio, video, and images are increasingly being labelled with distinct but undetectable marks that may contain a hidden copyright notice or serial number, or even directly help to prevent unauthorized duplication. This approach is extended to medical images by hiding secret information in them using the structure of a different file format. The hidden information may be related to the patient. In this paper, a method for hiding secret information in DICOM images is proposed based on Discrete Wavelet Transform (DWT). Firstly. segmented all slices of a 3D-image into a specific block size and collecting the host image depend on a generated key
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