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 lower Cretaceous sandstones of Zubair and Nahr Umr formations are the main producing reservoirs in Subba oilfield in southern Iraq. Key differences in their petrophysical and depositional attributes exist affecting their reservoir characteristics. The evaluation of well logs and core porosity-permeability data show better reservoir properties in Nahr Formation. The Litho-saturation logs indicate greater thickness of oil-saturated reservoir units for Nahr Unr Formation associated with lower values of shale volume, and higher values of effective porosity. In addition, higher values of permeability for Nahr Umr Formation is suggested by applying porosity-irreducible water saturation cross plot. The reducing reservoir quality of Zub
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The national pharmaceutical industry is pivotal for both the health sector and the national economy. This study aims to identify determinants of national drug products acceptance. The objectives of this study were to quantitatively measure the level of patient and community pharmacist acceptance of national drug products available in community pharmacies and to qualitatively explore the barriers facing national pharmaceutical companies and investigate the suggested solutions.
This cross-sectional study used an explanatory mixed method design. It was conducted in Baghdad, Iraq from July through October 2018. The stud
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Emotional blackmail is generally defined as manipulating others' emotions for personal gain. It is a type of manipulation that damages healthy relationships among people and turns them into toxic relations leaving the victim in a state of depression and under stress of losing something s/he holds dear. This study aims to identify the pragmatic techniques of emotional blackmail used by both blackmailers and victims in "No One Would Tell" (2018). To do so, the researchers developed an eclectic model comprising Forward and Frazier's (1997) emotional blackmail, Searle’s speech acts (1979), Brown and Levinson’s politeness strategies (1987), Culpeper’s impoliteness strategies (1996, 2005), and Mayfield's taxonomy of fallacy (2007)
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The report includes a group of symbols that are employed within a framework that gives a language of greater impact. This research discusses the problem of the semiotic employment of religious symbols in press reports published in the electronic press across two levels: Reading to perceive the visual message in its abstract form, and the second for re-understanding and interpretation, as this level gives semantics to reveal the implicit level of media messages through a set of semiotic criteria on which it was based to cut texts to reach the process of understanding and interpretation.
The report includes a group of symbols that are employed within a framework that gives a language of greater impact. This research discusses the p
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Verbal Antonyms: A research in the relationship in meaning Between the words in Arabic language
In his post colonial novel, In the Skin of a lion, the Canadian/Sri Lankan writer,
Michael Ondaatje is so interested in the term "Post colonialism" because he wants to show
that the term doesn't only refer to a period of time that comes after colonialism. In other
words, post colonialism is not only referred to as a literal description of formerly colonial
societies. He deals with the termas a literary genre and an academic construct that describes
the global conditions of a man after a period of colonialism. He shows that post colonialism is
a theory that tries to examine and explore the different styles and faces of European authority
to control the colonized. Ondaatje's attempt through such term is to unmask Europ
In this research, the electrical characteristics of glow discharge plasma were studied. Glow discharge plasma generated in a home-made DC magnetron sputtering system, and a DC-power supply of high voltage as input to the discharge electrodes were both utilized. The distance between two electrodes is 4cm. The gas used to produce plasma is argon gas which flows inside the chamber at a rate of 40 sccm. The influence of work function for different target materials (gold, copper, and silver), - 5cm in diameter and around 1mm thickness - different working pressures, and different applied voltages on electrical characteristics (discharge current, discharge potential, and Paschen’s curve) were studied. The results showed that the discharge cur
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