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.
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This article investigates Iraq wars presentation in literature and media. The first section investigates the case of the returnees from the war and their experience, their trauma and final presentation of that experience. The article also investigates how trauma and fear is depicted to create an optimized image and state of fear that could in turn show Iraqi society as a traumatized society. Critics such as Suzie Grogan believes that the concept of trauma could expand to influence societies rather than one individual after exposure to trauma of being involved in wars and different major conflicts. This is reflected in Iraq as a country that was subjected to six comprehensive conflicts in its recent history, i.e. less than half a century; th
... Show Morethe electron correlation effect for inter-shell can be described by evaluating the fermi hole and partial fermi hole for Li atom comparing with Be+ and B+2 ions
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An intuitionistic fuzzy set was exhibited by Atanassov in 1986 as a generalization of the fuzzy set. So, we introduce cubic intuitionistic structures on a KU-semigroup as a generalization of the fuzzy set of a KU-semigroup. A cubic intuitionistic k-ideal and some related properties are introduced. Also, a few characterizations of a cubic intuitionistic k-ideal are discussed and new cubic intuitionistic fuzzy sets in a KU-semigroup are defined.
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Ziziphora persica Bunge is recorded as a new Study in Iraq. This species has been collected from Jabal Sinjar in Nineveh province in the north western part of Iraq. The morphological characters, habitat and geographical distribution of the species with a key to Ziziphora L. species in Iraq have been provided.
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Background: Diabetic cheiroarthropathy is a term derived from the Greek word “cheiros” meaning “of the hand”, It is characterized by stiff hands with distinctively thick, tight, and waxy skin, especially on the dorsal aspects of the hands. It is part of long term complication of diabetes and many suggest it is associated with microvascular complication. The aim of the study was to determine the prevalence of diabetic cheiroarthropathy in Iraqi patients with diabetes, and to study its association with diabetic retinopathy and glycemic control. Material and Methods: A cross-sectional study in which 110 diabetic patients and 110 non-diabetic healthy people who accepted to take part in the study were ran
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