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.
The avoidance strategy of prey to predation and the predation strategy for predators are important topics in evolutionary biology. Both prey and predators adjust their behaviors in order to obtain the maximal benefits and to raise their biomass for each. Therefore, this paper is aimed at studying the impact of prey’s fear and group defense against predation on the dynamics of the food-web model. Consequently, in this paper, a mathematical model that describes a tritrophic Leslie-Gower food-web system is formulated. Sokol-Howell type of function response is adapted to describe the predation process due to the prey’s group defensive capability. The effects of fear due to the predation process are considered in the first two levels
... Show MoreDrawing upon the recent theoretical framework of Burkean concept of identification (ID), the current study aims at probing the interaction of content and form in two letters penned by Iran’s Supreme Leader and addressed to the Youth on Jan. and Nov. 2015. To this end, the study seeks (i) to determine a role ID takes in the conveyance of intended assumptions to the targeted readers; and (ii) to observe if the writer’s objectives, i.e. to identify himself with the readers and to realize his politically-religiously-infused creeds, result in success or failure; moreover, (iii) it seeks to determine how he achieved his end to attenuate the impacts of blazing inferno of Islamophobia and anti-Islam sentiments in his addressees. The who
... Show MoreThis study focused on the synthesis of novel polymers incorporating the 1,3,4-oxadiazole ring. Four polymers were specifically prepared by blending polymers (6-9) with polyvinyl alcohol (PVA) in defined ratios, resulting in the formation of blended polymers (10-13). The synthesized polymers were characterized using Fourier Transform Infrared (FTIR) spectroscopy and proton nuclear magnetic resonance (1H-NMR). The results showed that the structure aligned with the proposed synthetic polymers. Furthermore, the physical and thermal properties were studied using scanning electron microscopy (SEM), thermogravimetric analysis (TGA) and Differential Scanning Calorimetry (DSC). Additionally, the biological activity was examined against two s
... Show MoreWomen are considered the real power to build societies, as they are half of society, and it is their responsibility to raise generations، as human history testifies to the recording of great names with their giving and achievement in various scientific, social and humanitarian disciplines. Because of the importance of women in our lives, society must give them special care, whether at home or within the community structure to which they belong, so that they contribute to the image that brings about a transformation in the public scene, as well as providing them with support to take charge of bringing about change themselves, and this explains the interest of the press at all levels. Women's issues and topics through various journal
... Show MoreDiversity the terms and practice the organizational filed with different concepts and environment, which Iraqi environment part from them. Some organizational in Iraqi environment leave its basic oriented to agreement with the leader desire, their fore this research focus tow basic variable (organizational citizenship behavior & transparence), we supposition which is dependent to explanation the response variable (strategic leadership). The results justification in part and not justification in another part. For example the organizational citizenship behavior effect on some parte of the strategic leadership. The transparence have faraway to fly from the relation with organizational citizenship behavior and strategic leadershi
... Show MoreMaintenance of hospital buildings and its management are regarded as an important subject which needs attention because hospital buildings are service institutions which are very important to a society, requiring the search for the best procedure to develop maintenance in hospitals. The research is aimed to determine an equation to estimate the annual maintenance cost for public hospital. To achieve this aim, Al-Sader City Hospital maintenance system in Al-Najaf province has been studied with its main elements through survey of data, records and reports relating to maintenance during the years of the study 2008-2014 and to identify the strengths, weaknesses, opportunities and threat points in the current system through Swat analysi
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Background: Diabetes mellitus is a chronic disease with an increasing prevalence worldwide and characterized by an increase in oxidative stress and inflammation. The most important factor that is responsible for oxidative stress and production of reactive oxygen species (ROS) is hyperglycemia. The major targets of ROS are proteins. The most common and widely used biomarker of severe oxidative protein damage is protein carbonyl content.
The study was designed to assess the serum level of protein carbonyl as a marker of protein oxidation in patients with type 2 diabetes mellitus and to evaluate the effect of age, body weight, waist circumference, diabetic control and disease duration on the level
... Show MoreThe current study aims to apply the methods of evaluating investment decisions to extract the highest value and reduce the economic and environmental costs of the health sector according to the strategy.In order to achieve the objectives of the study, the researcher relied on the deductive approach in the theoretical aspect by collecting sources and previous studies. He also used the applied practical approach, relying on the data and reports of Amir almuminin Hospital for the period (2017-2031) for the purpose of evaluating investment decisions in the hospital. A set of conclusions, the most important of which is: The failure to apply
... Show MoreA specific, sensitive and new simple method was used for the determination of methyldopa in pure and pharmaceutical formulations by using continuous flow injection analysis. This method is based on formation of ion pair compound between methyldopa and potassium hexacyanoferrate in acidic medium to obtain a yellow precipitate complex using long distance chasing photometer (NAG-ADF-300-2). The linear range for calibration graph was 0.05-35 mmol/L for cell A and 0.05-25 mmol/L for cell B, and LOD 1.4292 µg /200 µL for both cells with correlation coefficient (r) 0.9981 for cell A and 0.9994 for cell B, RSD% was lower than 0.5 % for n=8 for. The results were compared with classical method UV-Spectrophotometric at λ max=280 nm and turbi
... Show MoreIn a report by Transparency Organization in 2010, Iraq has 200 newspapers, magazines, sixty-seven radio stations and 45 satellite TV channels. The increase in these figures is measured in days or weeks and not months and years. This fact confirms the importance of studying content providers, especially youth sports content, for two reasons: the first is that young people constitute the highest percentage in Iraqi society, with all the potential involved in shaping the future aspects; the second reason is that for years sport has become an important pillar in people's lives not only in the entertainment aspect as it was seen in the past; Rather, sport has an influential presence in politi
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