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 surgeryKeywords: Non-surgical treatment of anal fissure, fissure in ano, sphicterotomy,botulinum toxin in anal fissures, glyceryl trinitrate. Chemical sphincteratomy, pharmacological sphincteratomy.
The speech act of refusals has been studied widely either alone or in relation to such areas as apology, requests, promotion, and invitation. The present study aims to investigate the strategies employed by Iraqi females in refusing marriage proposals. It attempts to explore their preferences to respond directly or indirectly in relation to their ages and educational background of the parents. The sample of the study consists of 25 participants; they are learners of English as a foreign language (EFL) at the College of Education for Women/ University of Baghdad. The data are collected by using a discourse completion task (DCT) followed by a follow up interview. The researchers used a Google form shared via emails to get responses from the p
... Show MoreBackground: Osteoid osteoma(OO) is a relatively common benign skeletal neoplasm of unknown etiology that is composed of osteoid and woven bone, usually seen in adolescent and young males Although, the clinical, radiological and scintigraphic features of OO have been well described, these features may be misleading or altered in the cases of lesser trochanter of the femur which is relatively uncommon location for OO with a few number of cases reported up to date.Case Presentation: We report a case of a 20-year-old man who presented with painful limpThe pain had begun six months earlier and was made worse by walking and by exercise., with normal initial X-rays .The diagnosis was made after six months when typical Computed tomography, magne
... Show MoreThis paper introduces a relationship between the independence of polynomials associated with the links of the network, and the Jacobian determinant of these polynomials. Also, it presents a way to simplify a given communication network through an algorithm that splits the network into subnets and reintegrates them into a network that is a general representation or model of the studied network. This model is also represented through a combination of polynomial equations and uses Groebner bases to reach a new simplified network equivalent to the given network, which may make studying the ability to solve the problem of network coding less expensive and much easier.
<p>Photovoltaic (PV) systems are becoming increasingly popular; however, arc faults on the direct current (DC) side are becoming more widespread as a result of the effects of aging as well as the trend toward higher DC voltage levels, posing severe risk to human safety and system stability. The parallel arc faults present higher level of current as compared with the series arc faults, making it more difficult to spot the series arc. In this paper and for the aim of condition monitoring, the features of a DC series arc fault are analyzed by analysing the arc features, performing model’s simulation in PSCAD, and carrying out experimental studies. Various arc models are simulated and investigated; for low current arcs, the heur
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A new series polymers was synthesized from reaction starting material Bisacodyl A or [(2-Pyridinylmethylene) di-4, 1-phenylene di acetate] with hydrogen bromide, then the products were polymerized by addition polymerization from used adipoyl and glutaroyl chloride. The structure of these compounds was characterized by FT-IR, melting points, TLC, X-Ray, DSC and 1H-NMR for starting material. These compounds were also screened for their antibacterial activists?
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Let be a ring. Given two positive integers and , an module is said to be -presented, if there is an exact sequence of -modules with is -generated. A submodule of a right -module is said to be -pure in , if for every -Presented left -module the canonical map is a monomorphism. An -module has the -pure intersection property if the intersection of any two -pure submodules is again -pure. In this paper we give some characterizations, theorems and properties of modules with the -pure intersection property.
The oyster ??????? (planned) (Pallas) of lesions that have entered Iraq recently became spyware severe damage in more than a station from power plants in Iraq, including the power plant in Mussayab Vamahar accumulates in pipes cooling and disrupts their work Vtafrtf heat systems cooling and thereby determiningefficiency and lead to added cost many cleaning or replacement of damaged parts
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Graph is a tool that can be used to simplify and solve network problems. Domination is a typical network problem that graph theory is well suited for. A subset of nodes in any network is called dominating if every node is contained in this subset, or is connected to a node in it via an edge. Because of the importance of domination in different areas, variant types of domination have been introduced according to the purpose they are used for. In this paper, two domination parameters the first is the restrained and the second is secure domination have been chosn. The secure domination, and some types of restrained domination in one type of trees is called complete ary tree are determined.
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