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.
A stylistic study in the poetry of Hafiz Ibrahim, praise be to God, Lord of the worlds, and prayers and peace be upon his best messengers, and the seal of his prophets, Muhammad and his good and pure family, and after ...
The poet Hafez Ibrahim is considered one of the well-known poets in the modern era, and his language was distinguished by sobriety, eloquence in expressions, and beautiful meanings And he had my journey in the study of his poetry a stylistic study, and the research came with an introduction in which the concept of stylistics was briefly explained, since it was studied by many researchers, then divided the research into three topics: I studied in the first the construction of the poem, and I stood at the most importan
KE Sharquie, MM Al-Waiz, AA Al-Nuaimy, Saudi medical journal, 2002 - Cited by 11
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The Iraqi government seeks to overcome the financial crisis by investing and privatizing some projects to achieve sustainable growth. Most of the investment projects in Iraq suffer from many constraints that greatly impact the success of these projects. A survey of the opinions of a group of experts was conducted to identify the most important constraints facing the investment process in Iraq. Then the experts' answers were arranged in a closed questionnaire and distributed to the research sample for which the statistical analysis was conducted. Through it, the most important (17) factors that had the greatest impact on the failure of investment projects in Iraq were reached. One of the main constraints was
... Show MoreIn the field of implantology, peri-implantitis is still a common complication of implant failure. Similar to periodontal disease, this kind of pathological condition is characterized by inflammation of the tissues surrounding dental implants or fillings. The sources of infection have been shown to be chronic periodontitis and poor maintenance of the communion. A thorough examination of the intricate components of peri-implantitis was sought in this review in order to identify common characteristics of the disease with regard to bacteria, biofilm formation, host immunological responses, diagnostic tools, and therapeutic treatments. The aim of this study was to provide a detailed overview of the different bacterial species associated
... Show MoreThis work proposes a new video buffer framework (VBF) to acquire a favorable quality of experience (QoE) for video streaming in cellular networks. The proposed framework consists of three main parts: client selection algorithm, categorization method, and distribution mechanism. The client selection algorithm was named independent client selection algorithm (ICSA), which is proposed to select the best clients who have less interfering effects on video quality and recognize the clients’ urgency based on buffer occupancy level. In the categorization method, each frame in the video buffer is given a specific number for better estimation of the playout outage probability, so it can efficiently handle so many frames from different video
... Show MoreThis paper presents the intricate issues and strategies related to the translation of children's books, and it particularly focuses on the comparative analysis of "The Tale of Peter Rabbit" by Beatrix Potter and "Le Petit Prince" (The Little Prince) by Antoine de Saint-Exupéry. The study finds that the typical problems in translation are, idiomatic expressions, cultural reference, and the voice preservation, along side-sheet-specific challenges which each of the text faces. The translator of Potter's work should have skills of transposing all culturally oriented peculiarities of the UK land to the international audience to keep it accessible. On the contrary, "Le Petit Prince" translation will be the process of capturing the abstra
... Show MoreHuman Interactive Proofs (HIPs) are automatic inverse Turing tests, which are intended to differentiate between people and malicious computer programs. The mission of making good HIP system is a challenging issue, since the resultant HIP must be secure against attacks and in the same time it must be practical for humans. Text-based HIPs is one of the most popular HIPs types. It exploits the capability of humans to recite text images more than Optical Character Recognition (OCR), but the current text-based HIPs are not well-matched with rapid development of computer vision techniques, since they are either vey simply passed or very hard to resolve, thus this motivate that
... Show MoreThis study is an attempt to investigate the conceptual metaphor of UP and DOWN commonly used in Iraqi community. Some of the metaphorical expressions in Iraqi colloquial Arabicarewidely used by Iraqi speakers in everyday language. Ithas been analyzed by following the cognitive theory of metaphor (Lakoff& Johnson,1980).The study indicates that the Iraqi speakerexperiences more of the metaphorical expressions of UP and DOWN to referto many of the abstract concepts that shape his/her impression of everyday life situations.
Praise be to Allah , the Lord of Heavens , Who revealed His Scripture in plain Arabic, and prayers and peace be upon the Master of all creatures and the chosen one , Muhammad (PBUH).Pushkin was known as a poet in Russia, the sun of its poetry that set, the father of the Russian literature and the founder of its literary language. When he published his poems, trying to express his inner poetic feelings and creative visions, he presented them with creativity and special touch. The reason behind the selection of Pushkin as the subject of this study is that he was affected by Islam and Arabs. For the purpose of this study, the dissertation has been divided into introduction and three chapters; each chapter includes two topics. In the introdu
... Show MoreA Factorial Study for separation anxiety in students, of Baghdad City