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 theory of the psychologist’s Piaget states that man passes through four stages; other says that mankind passes through five. At each stage, human learn new characteristics, values, skills, and cultures from different environment that differ from one society to another. Therefore, the cultures of societies vary according to the diversity of the environments. These environments also vary depending on the circumstances surrounding them, e.g., in war environment, the individual learns what he does not learn from living in safe environment. As the environment changes, the communicative message also changes. This message is subject to person, groups, organizations and parties and directed to a diverse audience in its orientations and bel
... Show MoreIntrusion detection systems (IDS) are useful tools that help security administrators in the developing task to secure the network and alert in any possible harmful event. IDS can be classified either as misuse or anomaly, depending on the detection methodology. Where Misuse IDS can recognize the known attack based on their signatures, the main disadvantage of these systems is that they cannot detect new attacks. At the same time, the anomaly IDS depends on normal behaviour, where the main advantage of this system is its ability to discover new attacks. On the other hand, the main drawback of anomaly IDS is high false alarm rate results. Therefore, a hybrid IDS is a combination of misuse and anomaly and acts as a solution to overcome the dis
... Show MoreThis study is intended to examine the concept of transcultural identity in the travel book The Global Soul: Jet Lag, Shopping Malls, and the Search for Home by (Iyer, 2001). Jeffries’ model of critical stylistics (2010) (henceforth, CS) has been selected to analyze the book. To be more specific, Negation is selected to analyze the concept under study. As such, the study aims at finding out how Negation is used to portray ideological meanings representing the concept of transcultural identity in one non-fictional travel book; and finding out the ideologies related to the concept analyzed. The analysis of the data shows that Negation is a suitable analytical tool to reach the ideational meaning of the text towards the concept of tra
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The purpose of this study is to illuminate the role of CBCT in forensic dentistry through variations of mandibular measurements of Bonwill’s triangles in gender determination among the Iraqi population.
In this retrospective study 70 CBCT scans were analyzed to measure the Bonwill’s triangle, 35 for males and 35 for females aged between 20 and 50 years, all data were collected at the oral and maxillofacial radiology department in Ghazi AL-Hariri hospital for 3 months, and the data were obtained using a Kavo CBCT device (3D On De
Vagrancy is global problem, but its geographical distribution differs from one society
to another and from one place to another inside the same society.Till now there isn't a real factor that can explain the phenomenon, spite that economy plays aconstituent and distinguishing part, and spite the fact that Vagrancy is considered a realdeviation that can be compared with criminality level, and cannot be separated from its effecton family, local society and school. In addition to unprecedented work under heavily pressurethat attack to a minimum protection and safety. Vagrant may be a child, a teen, a young, or
even an old man. Vagrancy thus means different people with different ages and not onlyprecisely children. Vagrant is not neces
Background: Diabetes mellitus (DM) could be regarded as a set of chronic metabolic disorders which have a common aspect of hyperglycemia. The resistance in the peripheral actions of insulin or impaired insulin secretion could be the reason hepcidin which is a peptide hormone derived from liver, in systemic iron homeostasis is an essential regulator, and its lopsided production participates in the pathogenesis of iron disorders in spectrum. Osteoporosis often accompanies many diseases like ß-thalassemia, hemochromatosis, sickle liver diseases, cell disease and hemosiderosis featured by iron overload, evidences suggest that Iron overload and iron deficiency are suggested by evidences that they affect bone in a negative way, acting
... Show MoreContamination of surface and groundwater with excessive concentrations of fluoride is of significant health hazard. Adsorption of fluoride onto waste materials of no economic value could be a potential approach for the treatment of fluoride-bearing water. This experimental and modeling study was devoted to investigate for the first the fluoride removal using unmodified waste granular brick (WGB) in a fixed bed running in continuous mode. Characterization of WGB was carried out by FT-IR, SEM, and EDX analysis. The batch mode experiments showed that they were affected by several parameters including contact time, initial pH, and sorbent dosage. The best values of these parameters that provided maximum removal percent (82%) with the in
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The educational function of television is one of the basic functions in light of the technical development that included the specialized satellite channels in all its fields, including the educational field, as its role became parallel to the role of educational institutions. These studies are among the descriptive studies in terms of the type of study methodology that describes the phenomenon, interprets its and extract the results and relationships between the variables. The study sample was multistage (random and intentional) included the students of the sixth academic and literary preparatory stage in the city of Baghdad.
The study problem was summarized by the following main question:
( What are the motives for the exposure of
The corrosion behavior of mild sleet in saturated aerated and de-aerated Ca(OH)2 solution was investigated using electrochemical measurements. The work was carried out with small coupons immersed in solutions containing different quantities of NaCl in presence of various NaN02 concentrations as corrosion inhibitors. It has been found thal:(1 ) In presence of NaCl, the time required to reach O2 evolution potential in de-aerated Ca(OH)2 polarized at 10μA/cm 2 is function of inhibitor concentration and it becomes lass as NaN02 increases compared with zero presence indicating the effectiveness of N
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