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.
Background: This study aimed to determine the cephalometric values of tetragon analysis on a sample of Iraqi adults with normal occlusion. Material and methods: Forty digital true lateral cephalometric radiographs belong to 20 males and 20 females having normal dental relation were analyzed using AutoCAD program 2009. Descriptive statistics and sample comparison with Fastlicht norms were obtained. Results: The results showed that maxillary and mandibular incisors were more proclined and the maxillary/mandibular planes angle was lower in Iraqi sample than Caucasian sample. Conclusion: It's recommended to use result from this study when using tetragon analysis for Iraqis to get more accurate result.
A new efficient Two Derivative Runge-Kutta method (TDRK) of order five is developed for the numerical solution of the special first order ordinary differential equations (ODEs). The new method is derived using the property of First Same As Last (FSAL). We analyzed the stability of our method. The numerical results are presented to illustrate the efficiency of the new method in comparison with some well-known RK methods.
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The research is exposed to the concept of rough discourse in contemporary theater with a critical reading that takes the genealogical work as a starting point in deconstructing the references of rough discourse and pursuing its paths in the civilization and cultural framework and how it identifies aesthetically within the theatrical field and the extents of its procedural treatments in order to reveal it and clarify its limits and representations, as the research included the first chapter. (methodological framework), the second chapter (theoretical framework), which included two sections, the first took place under the title (rough dramatization), while the second topic took place under the title (rough drama), and the second chapter re
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The latest events in Iraq and notably the fall of Mosul in the summer of 2014 have marked a turning point in The modern history of Iraq. Violent terrorist groups have overrun a vast area comprising of many towns in mid and northern Iraq causing many casualties and mass migration. Despite Iraq’s long history of pain and suffering the events of the second half of the year 2014 have been the most violent ever witnessed. From this point of view the researcher has tried to identify specifically in this time and place the effect these events have had on the Iraqi artist and to understand how the Iraqi artists depicted this violence in their works of art. The research comprises four parts; the first looked at the language used and the and pro
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Museum education is of great importance to an appropriate representation of museums’ collections and exhibits, including traditional fashion. Therefore, museum educators/curators need to be equipped with the most essential skills in their profession in order to adequately present the museum’s history and holdings. This could be achieved through specialized training programs. However, Arab countries are still behind in terms of museum education. Therefore, this article aims to shed light on this issue by assessing the knowledge and skills possessed by museum educators/curators and how training programs could affect them