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.
By reading the book (Endless Forms Most Beautiful: The New Science of Evo Devo) by Sean B. Carroll, new horizons opened up about the nature of the formation of the living organism. Although he presented the idea that the artist was influenced by the material assets of nature in his holographic art formations, the new science of Evo-Devo (Evolutionary Developmental Science) provided models worth standing on when comparing the similarity of the formation of living organisms on the one hand, and the formation of works of art with holographic organic bodies on the other. But the excitement lies in the fact that the formation of living natural organisms is often driven by subtle intelligent mechanisms that are different from the mechanisms us
... Show MoreThis paper deals the prediction of the process of random spatial data of two properties, the first is called Primary variables and the second is called secondary variables , the method that were used in the prediction process for this type of data is technique Co-kriging , the method is usually used when the number of primary variables meant to predict for one of its elements is measured in a particular location a few (because of the cost or difficulty of obtaining them) compare with secondary variable which is the number of elements are available and highly correlated with primary variables, as was the&nbs
... Show MoreThe essay investigates the rise and development of the prose poem form in Iraqi poetry in the period during and after the 1980s Iraq–Iran war. The essay follows the legacy of Western experiments with form following the First World War and their impact on the development of form in Iraqi poetry culminating in the prose poem. The dominance of this form on poetic development in this period has a close relationship with the experience of warfare and the ensuing of the cultural changes in Iraq after 1980. Poets of the 1980s war used poetic form as a means of dissent. The prose poem became for them an inherently subversive form that reflected their disaffection with the political, cultural, and literary conflicts of the time. The prose poem in
... Show MoreABSTRACT Background: Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders affecting women in their reproductive age.It is characterized by anovulation or oligo-ovulation and hyperandrogensim.Androgen excess is the central defect in polycystic ovary syndrome. It is a complex disorder affects general health in addition to oral health.This study aimed to assess the gingival health status among a group of women with polycystic ovary syndrome as well as to estimate the levels of salivaryfree testosterone in unstimulated saliva in relation to gingival health condition. Materials and methods: Sixty two women with an age range 20-25 years old and with a body mass index range18.5-24.9 (normal weight) were included in this s
... Show MoreNitroso-R-salt is proposed as a sensitive spectrophotometric reagent for the determination of paracetamol in aqueous solution. The method is based on the reaction of paracetamol with iron(III) and subsequent reaction with nitroso-R-salt to yield a green colored complex with maximum absorption at 720 nm. Optimization of the experimental conditions was described. The calibration graph was linear in the concentration range of 0.1 – 2.0 ?g mL-1 paracetamol with a molar absorptivity of 6.9 × 104 L mol-1 cm-1. The method was successfully applied to the determination of paracetamol in pharmaceutical preparations without any interference from common excipients. The method has been statistically evaluated with British Pharmacopoeia method a
... Show MoreThe study of the tendencies of scientific research in specialized journalism through the three specialized levels, specifically the third level. It is referred to be a monthly, quarterly or annual magazine that follows the publication of the researches for new studies which have come to in every specialization. it is directed to the highly educated and is almost an alternative book. Thus, the subject is specialized and the audience is specialized.
The study aims in both its survey and field section at knowing the type of researches and their classification and the form, gender and the use of foreign sources and their scientific tank and the geographical position in addition to knowing the opinions of researchers and their satisfa
... Show MoreCriticism is inherently impolite and a face-threatening act generally leading to conflicts among interlocutors. It is equally challenging for both native and non-native speakers, and needs pre-planning before performing it. The current research examines the production of non-institutional criticism by Iraqi EFL university learners and American native speakers. More specifically, it explores to what extent Iraqi EFL learners and American native speakers vary in (i) performing criticism, (ii) mitigating criticism, and (iii) their pragmatic choices according to the contextual variables of power and distance. To collect data, a discourse-completion task was used to elicit written data from 20 Iraqi EFL learners and 20 American native speaker
... Show MoreThis work presents the use of laser diode in the fiber distributed data interface FDDI networks. FDDI uses optical fiber as a transmission media. This solves the problems resulted from the EMI, and noise. In addition it increases the security of transmission. A network with a ring topology consists of three computers was designed and implemented. The timed token protocol was used to achieve and control the process of communication over the ring. Nonreturn to zero inversion (NRZI) modulation was carried out as a part of the physical (PHY) sublayer. The optical system consists of a laser diode with wavelength of 820 nm and 2.5 mW maximum output power as a source, optical fiber as a channel, and positive intrinsic negative (PIN) photodiode
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