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.
Abstract That the child is aged 7 years, surrounded by information, knowledge and skillsvaried, which constitute the raw material of experience teaching and is in the rule of inputlearning, if received by the student of these data are positive, these data require research and audit, the style becomes more positive, effective, and then becomes the explorer, butnot done exploration efficiency without the visual, auditory and sensory owned by thechildren. So study aimed to identify the values of the optical track and explore mathematical and find the relationship between them. And use the descriptive approach in a manner the linkon the children of the first year of primary school age (6-7) years in my school Waziriya and Karkh, during the peri
... Show MoreImportance of study :
The interesting of industrial sector and developing it after corner stone. It is important to build economic balanced and get behind and front linkage for transformative industrials, and this is important to get balanced.
The value of transformative industry sector is more important than other sectors in economy, and this is reflect the capital in industrial sector .Industry sector is larger than other sectors ,so it regards the motive which moving the economic wheel .
The problem :
The research treats reduction and retreat the ind
... Show MoreThe application of physiological oxygen (physoxia) concentrations is becoming increasingly commonplace within a mammalian stem cell culture. Human mesenchymal stem cells (hMSCs) attract widespread interest for clinical application due to their unique immunomodulatory, multi-lineage potential, and regenerative capacities. Descriptions of the impact of physoxia on global DNA methylation patterns in hMSCs and the activity of enzymatic machinery responsible for its regulation remain limited. Human bone marrow-derived mesenchymal stem cells (BM-hMSCs, passage 1) isolated in reduced oxygen conditions displayed an upregulation of SOX2 in reduced oxygen conditions vs. air oxygen (21% O2, AO), while no change was noted for either OCT-4 or NA
... Show MoreMaterials recycling has a significant economic and environmental impact; as a result, steel, aluminium, plastic, and other recyclable materials have been pushed for use in construction materials. One of these recyclable materials is the crumb rubber, has been considered as a pavement component. The general behaviour of the composite rubber-hot mix asphalt system would be varied from that of the conventional rubber free mix. In this review, desirable characteristics of hot mix asphalt are highlighted first. Also, effect of gradation and the main types of rubber are specified. Afterward, many studies that considered the crumb rubber as a waste product and its associated mixture and modifiers are reviewed. The factors affect the crumb
... Show MoreIonic liquids (ILs) have been recognized for their potential as environmentally friendly solvents when compared to traditional organic solvents. Additionally, their function goes beyond that of solvents, and cocatalysts, as they frequently act as stabilizing agents and ligands for the metal-active species and intermediates in catalytic systems. This comprehensive review primarily focuses on the application of Pd-incorporated ILs in catalyzing cross-coupling Suzuki reactions. The responses play a vital role in creating a wide range of structurally diverse and highly functionalized organic compounds, focusing specifically on nucleopalladation Suzuki coupling reactions. The review provides a detailed summary of the reaction conditions, stereos
... 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 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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