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.
A study that collected 240 samples and divided into two groups: the first 120 samples were for diabetics and the second 120 samples were for healthy people, and each group included (90, 20.10) samples from the mouth, urine and vagina respectively, The results showed positive (28.67, 4.00, 1.67) isolates of Candida. In the mouth, urine and vagina, respectively, of diabetic patients compared to (9.33, 2.33, 5.00) positive isolates in the mouth, urine and vagina, respectively, in the healthy. The rate of positive isolates in women was high in women with diabetes and healthy, and it reached 25.33 and 9.00 isolates, respectively, compared with the rate of isolates in men with Candida disease for diabetic patients and healthy people 14.67 and 2.0
... Show MoreThe loose sand is subject to large settlement when it is exposed to high stresses. This settlement is due to the nature of the high drainage of sand, which displays foundations and constructions to a large danger. The densification of loose sandy soils is required to provide sufficient bearing capacity for the structures. Thus soil stabilization is used to avoid failure in the facilities. Traditional methods of stabilized sandy soil such as fly ash, bituminous, and cement often require an extended curing period. The use of polymers to stabilize sandy soils is more extensive nowadays because it does not require a long curing time in addition to being chemically stable. In this study, the effect of adding different percent
... Show MoreTerrorist crime is considered a serious act that outweighs all other crimes in terms of impact and result, because it has a wide range on societies, and it also contains a great thing of danger represented in its purpose, and here describing terrorism as a crime is a description that does not give the full right to this behavior or that it It abbreviates it and does not show its actual reality, given that terrorism contains several different crimes and the roles of its contributors, and these roles are necessary to reach the result or the end. In which each episode is complementary to the other, it is not a single act, but rather several joint and complex actions that in turn all lead to the result, and the agreement in the terrorist pro
... Show MoreAbstract
Theoretical and experimental methodologies were assessed to test curved beam made of layered composite material. The maximum stress and maximum deflection were computed for each layer and the effect of radius of curvature and curve shape on them. Because of the increase of the use of composite materials in aircraft structures and the renewed interest in these types of problems, the presented theoretical assessment was made using three different approaches: curved beam theory and an approximate 2D strength of material equations and finite element method (FEM) analysis by ANSYS 14.5 program for twelve cases of multi-layered cylindrical shell panel differs in fibe
... Show MoreThis study aims to develop a recommendation engine methodology to enhance the model’s effectiveness and efficiency. The proposed model is commonly used to assign or propose a limited number of developers with the required skills and expertise to address and resolve a bug report. Managing collections within bug repositories is the responsibility of software engineers in addressing specific defects. Identifying the optimal allocation of personnel to activities is challenging when dealing with software defects, which necessitates a substantial workforce of developers. Analyzing new scientific methodologies to enhance comprehension of the results is the purpose of this analysis. Additionally, developer priorities were discussed, especially th
... Show MorePraise be to God, Lord of the Worlds, and prayers and peace be upon the Master of Messengers, Muhammad and his family
The good and pure and after his companions
God Almighty said: ( ) Do they not contemplate the Qur’an? If it had been from other than God, they would have found in it much discrepancy. God Almighty has made the well-being of people and their lives linked to faith in it. So what is the need of people today to return to the Book of their Lord so that they may return to the right path that God intended for His servants so that they may attain sustenance? Security and the good life. How could it not be, when many of the nations of the world no longer see security or stability because their leaders and politic
... Show MoreAccording to the prevalence of multidrug resistance bacteria, especially Pseudomonas aeruginosa, in which the essential mechanism of drug resistance is the ability to possess an efflux pump by which extrusion of antimicrobial agents usually occurs, this study aims to detect the presence of mexB multidrug efflux gene in some local isolates of this bacteria that show resistance towards three antibiotics, out of five. Sensitivity test to antibiotics was performed on all isolates by using meropenem (10μg/disc), imipenem (10μg/disc), amikacin (30 μg/disc), ciprofloxacin (5μg/disc) and ceftazidime (30 μg/disc). Conventional PCR results showed the presence of mexB gene (244bp) in four isolates out of ten (40%). In addition,25, 50μg/ml of cur
... Show MoreDiyala river is the most important tributaries in Iraq, this river suffering from pollution, therefore, this research aimed to predict organic pollutants that represented by biological oxygen demand BOD, and inorganic pollutants that represented by total dissolved solids TDS for Diyala river in Iraq, the data used in this research were collected for the period from 2011-2016 for the last station in the river known as D17, before the river meeting Tigris river in Baghdad city. Analysis Neural Network ANN was used in order to find the mathematical models, the parameters used to predict BOD were seven parameters EC, Alk, Cl, K, TH, NO3, DO, after removing the less importance parameters. While the parameters that used to predict TDS were fourte
... Show MoreIn this paper, the density of state (DOS) at Fe metal contact to Titanium dioxide semiconductor (TiO2) has been studied and investigated using quantum consideration approaches. The study and calculations of (DOS) depended on the orientation and driving energies. was a function of TiO2 and Fe materials' refractive index and dielectric constant. Attention has focused on the effect of on the characteristic of (DOS), which increased with the increasing of refractive index and dielectric constant of Fe metal and vice versa. The results of (DOS) and its relation with and values of system have been discussed. As for contact system is increased, (DOS) values increased at first, but the relation is disturbed later and transforms into an inve
... Show MoreThe present study aimed to identify the availability of the National Council of Teachers of Mathematics (NCTM) standards in the content of mathematics textbooks at the basic education stage in the Sultanate of Oman. The study used the descriptive-analytical approach, adopting the method of content analysis through using a content analysis tool that included (43) indicators distributed on the four NCTM standards related to the field of geometry, after verifying their validity and reliability. The study population consisted of mathematics textbooks (first and second semesters) for ninth-grade students in the Sultanate of Oman in the academic year 2018/2019, while the sample consisted of Geometry units in the content of those books, which a
... Show More