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.
This research paper is about synoptic climate specifically with in the upper air layers
using upper air layers maps analysis which are maps of thickness for the level 1000 – 500
MB, that their high average ranges between 100 – 5600 M above surface. This research paper
focuses on studying special and temporal variations of the atmosphere thickness above Iraqaccording
to this study, it is concluded that atmosphere thickness above Iraq increases
towards south with an average of 100 M as compared with north of Iraq. Regarding the
temporal variations, it is concluded that atmosphere thickness during hot months. In July, for
example, the atmosphere thickness becomes thicker than in January with an average of
(250)M
This research aims to Presented model can be applicable – in the frame of current accounting implementations - to measure environmental effects and disclosure then in the financial statements of economic entities after determined the environmental performance scopes of environmental activities that is works by this entities , because of importance of accounting information which presentation by accounting systems which's effectiveness tool on hand of decision maker about site plans and goals and drawing policies aims protection environment sustainable the represented of naturalism wealth elements . The researcher could be able to application his suggested model which's proof the ability to environmental accounting measurement and discl
... Show MoreThis study examines the analysis of the contents of the international public relations campaign in confronting the Covid-19 virus, which was taken from the (Your Health is a Trust) campaign for the World Health Organization, Iraq office.The research problem revolves around a main question that is, what are the axes of the campaign (Your Health is a Trust) established by the World Health Organization (Iraq office) in the prevention of Covid 19 virus?From this main question, several sub-questions emerged that this study answered on their Facebook page, and the communication activities of the Covid-19 awareness campaign. In the content analysis form, as this form included a number of main themes and main categoriesthat were adopted in analyzin
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Background: Assessment is an important part of the learning cascade in education. Students realize it as an influential motivator to direct and guide their learning. The method of assessment determines the way the students reach high levels of learning. It has been documented that one of factor affecting students’ choice of learning approach is the way how assessment is being performed. Many methods of assessment namely multiple choice questions, essay questions and others are mainly used to assess basic science knowledge in undergraduate education. Objectives: The aim of this study is to compare multiple choice questions (MCQ) and essay questions (EQ) (record the success and failure rate of multiple choice questions (MCQ) and essay quest
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Background: Intestinal parasitic infections including amoebiasis, blastocystosis, giardiasis, are all worldwide distribution with harmful effects, it is an important cause of morbidity and death rate in the poor countries. Objective: This study was done to collect information of the frequency of these diseases in some regions of Baghdad. Our objectives are to detect the frequency of human pathogenic parasites in some regions of Baghdad in stool samples of patients who would attend to AL-Kindy Teaching Hospital, Medical City Teaching Hospital and to determine the most common age group affected. Materials and Methods: Data were collected from Al-Kindy Teaching Hospital and Medical City Teaching Hospital, in the lab of parasitology fro
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Groupwise non-rigid image alignment is a difficult non-linear optimization problem involving many parameters and often large datasets. Previous methods have explored various metrics and optimization strategies. Good results have been previously achieved with simple metrics, requiring complex optimization, often with many unintuitive parameters that require careful tuning for each dataset. In this chapter, the problem is restructured to use a simpler, iterative optimization algorithm, with very few free parameters. The warps are refined using an iterative Levenberg-Marquardt minimization to the mean, based on updating the locations of a small number of points and incorporating a stiffness constraint. This optimization approach is eff
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