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 synthesis of new benzodiazepine, imidazole, isatin, maleimide, pyrimidine and 1,2,4-triazole derived from 2-amino-4-hydroxy-1,3,5-triazine, via its cyclocondensation reaction with different organic reagents, is described. FT-IR, 1H-NMR and as well as 13C-NMR spectra disclosed the structures of the precursors and heterocyclic derivatives formed.
AI 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
... Show MoreThe open hole well log data (Resistivity, Sonic, and Gamma Ray) of well X in Euphrates subzone within the Mesopotamian basin are applied to detect the total organic carbon (TOC) of Zubair Formation in the south part of Iraq. The mathematical interpretation of the logs parameters helped in detecting the TOC and source rock productivity. As well, the quantitative interpretation of the logs data leads to assigning to the organic content and source rock intervals identification. The reactions of logs in relation to the increasing of TOC can be detected through logs parameters. By this way, the TOC can be predicted with an increase in gamma-ray, sonic, neutron, and resistivity, as well as a decrease in the density log
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The research sought to identify the crises that occurred during the research period and their reflection on the performance of the hotel Research sample as well as to identify the reality of auditing the hotel Research sample and the preparation of a performance audit program can be adopted in auditing the performance of hotels in light of crises, and the problem of the research lies in the lack of a program to audit the performance of hotels that takes into account the crises experienced by the hotel sector, The research was based on solving its problems on three hypotheses, the first is that the performance audit in light of the Covid-19 pand
... Show MoreSince the emergence of the science of international relations as an independent academic scientific field, various theories and trends have appeared and have tried to understand and explain the international reality and give a clear picture of what is happening within the international system of interactions and influences and the search for tools for stability and peace in international relations. Among these theories is the feminist theory, which is a new intellectual trend on the level of international relations theories, which tried to give an explanation of what is happening in world politics and in international relations in particular. The main issue that feminist theory is concerned with is the lack of women’s subordination
... Show MoreThe duty of care is the essence of the error of negligence under the English legal system, and without it, responsibility for negligence cannot be judged, regardless of the extent of the damage incurred. contained in English law. In view of the importance of proving the existence of the duty of care on the defendant so that it is possible to judge his responsibility for negligence, the need arises to find a general principle to which the defendant is subject in order to decide whether he owes the plaintiff with the duty of care and therefore responsible for the negligence, and this is what we will explain in the research topic the study.
The extract of fig fruit has shown significant medical usefulness in various fields. The entrance of nanotechnology into the field of medicinal and pharmacology has shown remarkable advantages. Plants contain diverse molecules thatcan reduce metals, and provide a safe, eco-friendly approach for synthesizing nanoparticles. Iron oxide nanoparticles (IONPs) have been reported to possess an antimicrobial effect against some strains of bacteria and moulds. We have aimed to synthesize IONPs from fig fruit extract and investigate the influence of fig extract and IONPs in wound healing of mice. UV-Vis spectroscopy, X-ray diffraction (XRD), and field emission scanning electron microscopy were used to characterize the IONPs that were produced
... Show MoreLying is a controversial issue as it is closely related to one's intended meaning to achieve certain pragmatic functions. The use of lying in literary works is closely related to the characters’ pragmatic functions as in the case of Miller's The Crucible where it is used as a deceptive complex phenomenon that cannot be observed out of context. That is, the use of lying as a deceptive phenomenon represents a violation to Grices's Maxims. Thus, the study aims to qualitatively examine the kinds of maxims being violated, the kinds of violations conducted, the strategies followed in the violations, and the pragmatic functions behind such violations across the different categories of lies. To this end, the (30) extracts fou
... Show MoreThis abstract focuses on the significance of wireless body area networks (WBANs) as a cutting-edge and self-governing technology, which has garnered substantial attention from researchers. The central challenge faced by WBANs revolves around upholding quality of service (QoS) within rapidly evolving sectors like healthcare. The intricate task of managing diverse traffic types with limited resources further compounds this challenge. Particularly in medical WBANs, the prioritization of vital data is crucial to ensure prompt delivery of critical information. Given the stringent requirements of these systems, any data loss or delays are untenable, necessitating the implementation of intelligent algorithms. These algorithms play a pivota
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