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.
Investment in high education is considered to be most important factors of production which the return an individual and social than economic returns found by searching the growing problem of unemployment, especially among youth graduates, where the unemployment rate in 2010 (50%) of these high rates have led to increased migration of scientific minds graduate recently, "to search for job opportunities outside Iraq for not hiring functions and this is in vain" clear "in the human and financial resources lead to structural imbalances in the Iraqi economy. When calculating the correlation coefficient between the graduates and the unemployment rate where it reached (0.21) emerged from the results of
... Show MoreThis work describes the effect of temperature on the phase transformation of titanium dioxide (TiO2) prepared using metal organic precursors as starting materials. X-ray diffraction (XRD) was used to investigate the structural properties of TiO2 gels calcined at different temperatures (300, 500, 700) ?C. the results showed that the samples have typical peaks of TiO2 polycrystalline brookite nanopowders after calcined at (300 ?C), which confirmed by (111), (121), (200), (012), (131), (220), (040), (231), (132) and (232) diffraction peaks. Also, XRD diffraction spectra showed the presence of crystallites of anatase with low proportion of rutile phase where calcined at (500 ?C), while rutile phase domains at (700 ?C). The crystallite size of
... Show MoreThe main object of this paper is to study the representations of monomial groups and characters technique for representations of monomial groups. We refer to monomial groups by M-groups. Moreover we investigate the relation of monomial groups and solvable groups. Many applications have been given the symbol G e.g. group of order 297 is an M-group and solvable. For any group G, the factor group G/G? (G? is the derived subgroup of G) is an M-group in particular if G = Sn, SL(4,R).
Investigation of the adsorption of Chromium (VI) on Fe3O4 is carried out using batch scale experiments according to statistical design using a software program minitab17 (Box-Behnken design). Experiments were carried out as per Box-Behnken design with four input parameters such as pH (2-8), initial concentration (50–150mg/L), adsorbent dosage (0.05–0.3 g) and time of adsorption (10–60min). The better conditions were showed at pH: 2; contact time: 60 min; chromium concentration: 50 mg/L and magnetite dosage: 0.3 g for maximum Chromium (VI) removal of (98.95%) with an error of 1.08%. The three models (Freundlich, Langmuir, and Temkin) were fitted to experimental data, Langmuir isotherm has bette
... Show MoreThe article considers metaphors as one of the fundamental means used by L. Ulitskaya when writing the family chronicle "Medea and her Children" (1996), for the formation of images of heroines - representatives of the pronounced feminine principle in the work. Here I describe the results of the next stage of research related to the work of Lyudmila Evgenievna Ulitskaya as a representative of modern Russian prose.
Haruki Murakami (1949-present) is a contemporary Japanese writer whose works have been translated into fifty languages and won him plenty of Japanese and international awards. His short stories are well constructed in a weird realistic manner and are mixed with elements of surrealism. His novels and short stories fall under the genre of magical realism. One of the major revolving themes that Murakami wrote about was the haunting feeling of emptiness and disconnectedness in a world which seems to care much for materialism and self-interests.
The paper explores two of Murakami’s short stories in his book After the Quake (2000) and the relevance of their themes and characters to Iraq after the q
... Show MoreThe current research deals with the dialectical relationship resulting from the conflict in the violent combination and construction of the living ( the actor)and the dead (the item) in the structure of the Sinography construction and the emergence of the theatrical play space , which can be summed up by the following question: what is the nature of the dialectical relationship between the living (the actor) and the dead( the item) in the Sinography creation, which limited the research in a central objective : to identify the controversy of the living (actor) and the dead (item) in the performance unit of the theatrical scene . The research, in its objective limits set forth in its methodological framework, analyzes this controversy in o
... Show MoreArt education is one among the fundamental subjects for elementary school students, because it contributes to assembling learners’ personalities and developing their technical skills. For this reason, this research comes, which aims to understand the effect of the task groups’ strategy in developing the performance of elementary school students in art education. to realize the goal of the research, the researcher put the subsequent hypotheses:
-There is not any statistically significant difference at the amount (5%) between the typical many students between the experimental group that studied consistent with the strategy of task groups and therefore the control group that studied in keeping with the same old method that they obt
Objectives: To find out the effectiveness of education program application on nurses-midwives' knowledge toward prevention and management of postpartum hemorrhage in delivery room and some socio demographic characteristics Methodology: a quasi -experimental "test-retest"design has carried throughout the present study with the application of a pre –test and post- test for nurses-midwives' knowledge toward postpartum hemorrhage. The study was conducted in six hospitals in Baghdad: Fatima Al – Zahra for Maternity and Pediatric, Al -Elwia maternity, Baghdad Teaching, AL-Imamine Al - Kadhimin Teaching, Al-Karckh maternity and Al-Yarmouk Teaching hospital for the period from 27th May
... Show MoreThe extraction of Basil oil from Iraqi Ocimum basillicum leaves using n-hexane and petroleum ether as organic solvents were studied and compared. The concentration of oil has been determined in a variety of extraction temperatures and agitation speed. The solvent to solid ratio effect has been studied in order to evaluate the concentration of Ocimum basillicum oil. The optimum experimental conditions for the oil extraction were established as follows: n-hexane as organic solvent, 60 °C extraction temperature, 300 rpm agitation speed and 40:1mL:g amount of solvent to solid ratio.