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 design was distinguished in Late Twenty-First Century With new and new methods Through which the ability to adapt all technical media in the formation of two-dimensional and three-dimensional figures and shapes was achieved .
Which led to the emergence of endless sets of design ideas characterized by the heterogeneity of design forms and design solutions that preceded it. The designer could not access these creations in various architectural and artistic fields only through computer programs, especially those related to the activation of mathematical logic and what is known as algorithms in the formation and construction of the form, which led to the emergence of the "parametric direction" and the problem of research is summarized
This paper analysed the effect of electronic internal auditing (EIA) based on the Control Objectives for Information and Related Technologies (COBIT) framework. Organisations must implement an up-to-date accounting information system (AIS) capable of meeting their auditing requirements. Electronic audit risk (compliance assessment, control assurance, and risk assessment) is a development by Weidenmier and Ramamoorti (2006) to improve AIS. In order to fulfil the study’s objectives, a questionnaire was prepared and distributed to a sample comprising 120 employees. The employees were financial managers, internal auditors, and workers involved in the company’s information security departments in the General Company for Electricity D
... Show MoreThe aim of this study was to know the inhibition activity of squeezed grape waste extract on Bacillus stearpthermophilus by using three different tempretures degree 40, 60 and 80c, in order to reduce the time exposure of food for preservation. This study include two branchs: First: isolation and identification of Bacillus stearothermophilus from soil, 5 sample were collected from the soil of the college agriculture/Baghdad university. Samples were cultured on nutrient agar, microscopic and culturing tests were conducted and many biochemical tests were done. The isolates were cultivated at 55 c and 65 c for differentiate it from Bacillus coagulans which is can't grow at 65 co. The c
... Show MoreNowadays, cloud computing has attracted the attention of large companies due to its high potential, flexibility, and profitability in providing multi-sources of hardware and software to serve the connected users. Given the scale of modern data centers and the dynamic nature of their resource provisioning, we need effective scheduling techniques to manage these resources while satisfying both the cloud providers and cloud users goals. Task scheduling in cloud computing is considered as NP-hard problem which cannot be easily solved by classical optimization methods. Thus, both heuristic and meta-heuristic techniques have been utilized to provide optimal or near-optimal solutions within an acceptable time frame for such problems. In th
... Show MorePiperine, a crystalline alkaloid compound isolated from Piper nigrum, piper longum, and other types of piper, has had many fabulous pharmacological advantages for preventing and treating some specific diseases, such as analgesic, anti-inflammatory, hepatoprotective, antimetastatic, antithyroid, immunomodulatory, antitumor, rheumatoid arthritis, osteoarthritis, Alzheimer's, and improving the bioavailability of other drugs. However, its potential for clinical use through oral usage is hindered by water solubility and poor bioavailability. The low level of oral bioavailability is caused by low solubility in water and is photosensitive, susceptible to isomerization by UV light, which causes piperine concentration to decrease. Many different
... Show MoreAI in teaching English is reshaping language learning. While interest in AI-supported education is growing worldwide, research in this area is still emerging in Iraq. This review synthesizes empirical AI-based intervention studies to enhance English language learning in Iraqi higher education, and the perceptions of stakeholders regarding AI tools in language instruction. The reviewed intervention studies, comprising studies employed different AI platforms to support grammar instruction, speaking fluency, writing feedback, and pragmatic competence. These interventions yielded improvements in learners’ performance, motivation, and communicative confidence. In parallel, perception-focused studies revealed positive attitudes toward A
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