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 principal concern of this study is Disjunct and Conjunct adverbials in the
English language. The study sets out to explore and clarify the types, nature and
structure of disjuncts and conjuncts. It also aims at testing student's performance to
evaluate the use and usage of the disjuncts and conjuncts in their written performance.
Two tests, accordingly, were given to some fifty students of at the Dept. of English, at
the college of languages (third and fourth stages) in the University of Sulaimani. The
hypothesis that the study was based on are those students use disjuncts and conjuncts
hardly enough in their writings and when doing so, they generally tend to stick only to
the most commonly used and familiar o
<span lang="EN-US">The fundamental of a downlink massive multiple-input multiple-output (MIMO) energy- issue efficiency strategy is known as minimum mean squared error (MMSE) implementation degrades the performance of a downlink massive MIMO energy-efficiency scheme, so some improvements are adding for this precoding scheme to improve its workthat is called our proposal solution as a proposed improved MMSE precoder (PIMP). The energy efficiency (EE) study has also taken into mind drastically lowering radiated power while maintaining high throughput and minimizing interference issues. We further find the tradeoff between spectral efficiency (SE) and EE although they coincide at the beginning but later their interests become con
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Background: Hypertension is probably the most important public health problem around the world. People with periodontal disease may be at greater risk of hypertension. The inflammatory effects of periodontal disease help to promote endothelial dysfunction in arteries which may lead to changes in blood pressure. Salivary MMP-8 has been associated with both periodontal disease and prevalent hypertension. Aim of study: This study was conducted to measure salivary matrix metalloproteinase - 8, in relation to periodontal health condition among a group of patients with hypertension in comparison with control group. Materials and methods: Ninety subjects, aged 45-50 years old were included in this study, seeking treatment for chest pain in Ibn-A
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Abstract
This research aims to develop a unit as part of a sixth-grade Arabic language textbook and measure its effectiveness in the development of twenty-first-century skills of female students. The author adopted the experimental approach with a quasi-experimental design of the pre-post single-group. A list of the major skills was derived from the framework for the 21st-century skills of the mother tongue that was developed by the Partnership for 21st-Century Skills and reviewed and adjusted by some specialists. According to their views, the unit was developed. The study targeted 15 sub-skills falling under three main skills. The results of the study showed the effectiveness of the developed unit in the develo
... Show MoreTitanium dioxide TiO2 has been widely utilized in cleaning and sterilizing material for many clinical tools sanitary ware, food tableware and cooking and items for use in hospitals. Titanium dioxide TiO2 non toxicity and long term physical and chemical stability. It has been widely used decomposition of organic compounds and microbial organisms such as cancer cell, viruses and bacteria as well as its potential application in sterilization of medical devices. The aim of the study the effect of titanium dioxide TiO2 on some Gram negative bacteria and study their effects on some virulence factors and chromosomal DNA.In this study, we obtained (E. coli ? Proteus mirabilis, Proteus vulgaris ? Pseudomonas aeruginosa ? Klebsiella pneumonia and Ac
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An experimental study is carried out on the effect of vortex generators (Circular and square) on the flow and heat transfer at variable locations at (X = 0.5, 1.5, 2.5 cm) ahead of a heat exchanger with Reynolds number ranging from 62000< Re < 125000 and heat flux from 3000 ≤ q ≤ 8000 W/m2 .
In the experimental investigation, an apparatus is set up to measure the velocity and temperatures around the heat exchanger.
The results show that there is an effect for using vortex generators on heat transfer. Also, heat transfer depends on the shape and location. The circular is found t
... Show MoreAIM: The aim of this study was to measure the prevalence of myeloproliferative disorders in a sample of Iraqi patients and to measure the changes in patients’ blood parameters. BACKGROUND: Myeloproliferative disorders are a group of neoplasms affecting the bone marrow progenitor cells characterized by excess cells with a risk of transforming to acute leukemia. There is a gap in knowledge about the prevalence of Iraqi population. Thus, we investigated the prevalence and distribution of different types of myeloproliferative disorders in a sample of Iraqi patients. MATERIALS AND METHODS: Cross-sectional study is done at the National Center of Hematology from November 2019 till March 2020 on 75 patients who were diagnosed
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A field experiment was carried out in the College of Agricultural Engineering Sciences - University of Baghdad, during the fall season of 2021 to find out which cultivated cultivars of maize are efficient under nitrogen fertilization. The experiment was applied according to an RCBD (split-plot design with three replications). The cultivars of the experiment (Baghdad, 5018, Sarah) supply three levels of nitrogen fertilizer, which are N1 (100 kg.N/ha), N2 (200 kg.N/ha) and N3 (300 kg.N/ha). The statistical analysis results showed the superiority of the Sarah genotype, which gave the highest value of SOD and CAT enzymes, reaching 11.59 units mg-1 and 10.76 units mg-1 . Protein sequentially, while cultivar5018 outperformed as it gave th
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