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.
Previous studies on the synthesis and characterization of metal chelates with uracil by elemental analysis, conductivity, IR, UV-Vis, NMR spectroscopy, and thermal analysis were covered in this review article. Reviewing these studies, we found that uracil can be coordinated through the electron pair on the N1, N3, O2, or O4 atoms. If the uracil was a mono-dentate ligand, it will be coordinated by one of the following atoms: N1, N3 or O2. But if the uracil was bi-dentate ligand, it will be coordinated by atoms N1 and O2, N3 and O2 or N3 and O4. However, when uracil forms complexes in the form of polymers, coordination occurs through the following atoms: N1 and N3 or N1 and O4.
he study aims to build a model that revolves around the main question of the role of strategic agility (SA) in enhancing organizational excellence (OE). For the purpose of achieving OE and to determine the extent of interest and knowledge of managers at the Midwest Refineries Company (MRC) on the theoretical and practical implications, and on the performance foundations of these two vital variables with the aim of continuous improvement. A questionnaire was used and distributed to a random sample of 54 managers in this important energy production company. The study followed the descriptive analytical approach to answer the questions raised. The study model and dimensions were built according to reference models, most notably the models (Al-
... Show MoreA study of irrigation water was conducted Baghdad city to find out extent of its pollution by some heavy metals (Pb, Cd, Ni, Co, CU, Cr, Zn and Fe). Water samples were collected randomly from different sources (river, well and stream). Results showed that the concentration of studied heavy metals were as follows: Lead between 0.43-11.75 mg L-1, Cadmium between 0.01-0.95 mg L-1, Nickel between 0.008-0.46 mg L-1, Cobalt between Nil - 0.185 mg L-1, Copper is between 0.326 - 1.58 mg L-1, Chromium is between Nil-0.068 mg L-1, Zinc 0.398-1.182 mg L-1, as for Iro
Abstract The aim of this paper is to shed light on the theme of Gender Struggle and Women’s Predicament in Tennessee Williams’ A Street Car Named Desire .The paper tries to show William's dealings with the critical social themes like Men's Brutality and women's predicament. The paper exposes the complete shift of the balance of power between the genders in America after the two world wars. Williams illustrates society’s changing attitudes towards masculinity and denounces the society's attitudes towards women in America at that time. He rebels against the cruelty of the modern age and regrets the disintegration of the values of the south and their being replaced by the disruptive forces of modern life. In the end of the play, brutalit
... Show MoreBinary relations or interactions among bio-entities, such as proteins, set up the essential part of any living biological system. Protein-protein interactions are usually structured in a graph data structure called "protein-protein interaction networks" (PPINs). Analysis of PPINs into complexes tries to lay out the significant knowledge needed to answer many unresolved questions, including how cells are organized and how proteins work. However, complex detection problems fall under the category of non-deterministic polynomial-time hard (NP-Hard) problems due to their computational complexity. To accommodate such combinatorial explosions, evolutionary algorithms (EAs) are proven effective alternatives to heuristics in solvin
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This research dealt with highlighting the images of marriage through the modern means of communication and the legal ruling for it. Dowry even be knotted on them; because they are then one of the parties to the contract and contracted in one contract, and this is prohibited by law and law and common sense.
It turns out that it is permissible to advertise marriage through the Internet in accordance with the rules and standards that preserve values and morals and safeguard dignity and chastity. The acts in Islamic law are vested with intentions. If intentions are true, then the act is true, and Internet marriage is what falls under this order.<
... Show MoreA concept of indoor solar illumination is described and simulated. The solar illumination system is composed of a tracking primary reflector, a selective secondary reflector, a visible light guide and a scattering solid glass tube fixture. Each part of the solar illumination system is optically suited and compatible with other parts to realize high efficiency. The simulation is conducted for Baghdad city for a library hall. Two major days over a year are chosen to investigate the illumination system for acceptable visible light level for reading hall. The two days are: summer solstice day and winter solstice day at 8:00 AM and 12:00 PM for each. Research results showed that the design of the solar system is achieved on the base of minimu
... Show MoreAddressed the problem of the research is marked: (Performing processors for the time between Impressionism and superrealism) the concept of time and how to submit artwork. The search came in four sections: general framework for research and identified the research problem and the need for him. With an indication of the importance of his presence. Then determine the research objectives of (detection processors performing to the concept of time in works of art in each of Impressionism and superrealism. And a comparison between them to reveal similarities and differences), followed by the establishment of boundaries Find three (objectivity, the temporal and spatial) were then determine the terms related to the title. Then provide the theore
... Show MoreThe electrical activity of the heart and the electrocardiogram (ECG) signal are fundamentally related. In the study that has been published, the ECG signal has been examined and used for a number of applications. The monitoring of heart rate and the analysis of heart rhythm patterns, the detection and diagnosis of cardiac diseases, the identification of emotional states, and the use of biometric identification methods are a few examples of applications in the field. Several various phases may be involved in the analysis of electrocardiogram (ECG) data, depending on the type of study being done. Preprocessing, feature extraction, feature selection, feature modification, and classification are frequently included in these stages. Ever
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