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.
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Objective: Aimed to asses the role of PT estimation in early diagnosis and predicting the extent and the outcome of head injury with ICerH and/ or Contusion
Method :PT was measured by Digiclot 818
Group –1: One hundred consecutive head injured patients admitted at Neurosurgical and Al Ramadi teaching hospitals were initially estimated for prothrombin time and subsequently scanned
Group-2 : Two hundred twenty five consecutive non scanned head injured patients admitted to Neurosurgical and Al Ramadi teaching hospitals were estimated with prothrombin time at the time of insult and subsequently for the next two weeks Al – Kindy Col Med J 2012; Vol. 8 No. 1 P: 54
Clinical and neurological evaluation (GCS) score in addition to
Depp and Heard's trial has reaped significant attention due to the domestic violence allegations directed towards each other. This paper sheds light on the repressed narrative beyond the mere words spoken aloud. It delves into an overlooked aspect, i.e., nonverbal communication. Previous studies focused on one or two categories of nonverbal communication. Therefore, the current study investigates the types and sub-types of nonverbal communication exhibited by both rivals within the courtroom setting. To examine the credibility and repressibility of nonverbal communication, the researchers have carefully watched (28) videos representing the whole trial's event. Some nonverbal communication was traced through the whole (28) videos fro
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Preserving the Past and Building the Future: A Sustainable Urban Plan for Mosul, Iraq
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The present work aims to improve the flux of forward osmosis with the use of Thin Film Composite membrane by reducing the effect of polarization on draw solution (brine solution) side.This study was conducted in two parts. The first is under the effect of polarization in which the flux and the water permeability coefficient (A) were calculated. In the second part of the study the experiments were repeated using a circulating pump at various speeds to make turbulence and reduce the effect of polarization on the brine solution side.
A model capable of predicting water permeability coefficient has been derived, and this is given by the following equations:
Z=Z0 +C.R.T/9.8(d2/D2+1) [Exp. [-9.8(d
Rwanga (view) movement is a new Kurdish poetry movement. Some poets and modern storywriters published a manifest in 1970. They have made a group of changes in the content and appearance of Kurdish poetry. They were under the influence of western literature schools such as Surrealism, Dadaism and Existentialism. Likewise, the impact of the new Arabic literature that appeared by the end of 1960s on them was obvious as they were imitating such literatures. Nevertheless, the condition of Kurdistan at that time was in need of a new literature to express that new stage. Sherko Bekas was one of those poets who became the dynamo of the poetic movement in which the rebellion spirit was embodied in the modern way of dealing with culture, rhyme, rh
... Show MoreThe research aims to build a training program to develop the willpower in the kindergarten children. In order to achieve the objective of the research, the two researchers have developed a Training Program according to the following steps:
- Determining the general objective of the Training Program.
- Determining the behavioral objectives of the Training Program.
- Determining the content of the Training Program.
- Implementing the content of the Training Program sessions.
- Evaluating the Training Program.
The training program consisted of (15) sessions, each session included a set of parts (title, general objective, methods, time and place to implement the sessions, behavioral goals, tool
... Show MoreMembrane distillation (MD) is a hopeful desalination technique for brine (salty) water. In this research, Direct Contact Membrane Distillation (DCMD) and Air Gap Membrane Distillation (AGMD) will be used. The sample used is from Shat Al –Arab water (TDS=2430 mg/l). A polyvinylidene fluoride (PVDF) flat sheet membrane was used as a flat sheet form with a plate and frame cell. Several parameters were studied, such as; operation time, feed temperature, permeate temperature, feed flow rate. The results showed that with time, the flux decreases because of the accumulated fouling and scaling on the membrane surface. Feed temperature and feed flow rate had a positive effect on the permeate flux, while permeate temperatu
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In this study, ultraviolet (UV), ozone techniques with hydrogen peroxide oxidant were used to treat the wastewater which is produced from South Baghdad Power Station using lab-scale system. From UV-H2O2 experiments, it was shown that the optimum exposure time was 80 min. At this time, the highest removal percentages of oil, COD, and TOC were 84.69 %, 56.33 % and 50 % respectively. Effect of pH on the contaminants removing was studied in the range of (2-12). The best oil, COD, and TOC removal percentages (69.38 %, 70 % and 52 %) using H2O2/UV were at pH=12. H2O2/ozone experiments exhibited better performance compared to
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It is more beneficial science and created and the highest honor is the Koran Sciences, God has honored research in this fun science, came this research that shed the light on the radical incision, and Naughty derivatives as contained in the Koran, and illustrate the diversity of Saghma morphological, and fork them from derivatives what it entailed connotations, as well as the evacuation of cryptic in some of these verses from the biological secrets take minds newly exposed Anitrjt science under the name of scientific miracles.
The research methodology is revenue verse which included the word, and revenue lexical meaning and its meaning in the context of the Qur'an, and reflect the views of the commentators of the verse, and then the r