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.
Background: The primary stability of the dental implant is a crucial factor determining the ability to initiate temporary implant-supported prosthesis and for subsequent successful osseointegration, especially in the maxillary non-molar sites. This study assessed the reliability of the insertion torque of dental implants by relating it to the implant stability quotient values measured by the Osstell device. Material and methods: This study included healthy, non-smoker patients with no history of diabetes or other metabolic, or debilitating diseases that may affect bone healing, having non-restorable fractured teeth and retained roots in the maxillary non-molar sites. Primary dental implant stability was evaluated using a torque ratc
... Show More5-Fluorouracil is one of the commonly used chemotherapy drugs in anticancer therapy; unfortunately treatment with 5-FU by solely has many drawbacks low lipophilicity, low permeability, low molecular weight, and its relatively poor plasma protein binding; also a brief half-life therefore frequent administration is required to maintain the optimal therapeutic plasma level which in addition to its poor selectivity, drug resistance and limited penetration to cancer cells; leads to increased incidence of side-effects to healthy cells/tissues and low response rates. In order to minimize these drawbacks; 5-FU was chemically conjugated with pyrrolidine dithiocarbamate (PDTC) in a mutual prodrug moiety (S-(9H-purin-6-yl) 3-(
... Show MoreIntellectual and material displacement is one of the design strategies through many mechanisms and means, and depends on the idea of changing the shape within the internal spaces at times and has concepts related to the transformation at other times. And represented by the boxes for travelers, the research problem emerged through the following question: (What is the effectiveness of displacement in the formal structures in the interior design of historical sites), and the aim of the study is to reveal the reality of the use of historical internal spaces and to determine the formal displacement that occurs as a result of change and transformation, and it included two topics, the first topic Transformation and the effectiveness of formal d
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This research was interested in studying the phrase “I don’t know” in the Lisan al-Arab dictionary, and Lisan al-Arab was based on collecting its material from five dictionaries, including: Tahdhib al-Lugha, al-Muqamah, al-Sahih, and the footnotes of Ibn Berri, al-Nihaya and Gharib al-Hadith. The objection to this phrase, and the discussion of its various implications among linguists and the clarification of the closest and most famous content to it according to the data presented to the researcher in his research journey, and to reach this goal, the research division into a preface, five demands and a conclusion and followed the list of sources and references. To define the lexicon of Lisan al-Ar
... Show MoreIraq is one of the most important countries in the world that has received its share of terrorist acts by the terrorist organization the Islamic State of Iraq and al-Sham (ISIS), which has caused instability, especially during the period of ISIS's control of seven Iraqi provinces (2014-2017). This stage has caused a decline in the levels of human and economic development and its inconsistency with the capabilities and needs of the Iraqi population. Therefore, this study aims to investigate the hypothesis that there is a close relationship between the decline in development in Iraq and the brutal practices of ISIS that it committed during his period of control over many Iraqi cities and regions. This study used several method
... Show MoreThis research amid to measure the impact of organizational flexibility (structural flexibility, operational flexibility, and strategic flexibility) in achieving organizational prosperity and its dimensions (strategic agility, intellectual capital, innovation and sustainable competitive advantage) in a number of Iraqi cellular communications companies. The research adopted descriptive analytical approach. A sample of (85) persons from the research community was selected, which included (Department managers, Directors administrative units, Communication engineers), to answer the questionnaire prepared for this purpose. And to analyze data and derive results. Statist
... Show MoreThe aim of this paper is to derive a posteriori error estimates for semilinear parabolic interface problems. More specifically, optimal order a posteriori error analysis in the - norm for semidiscrete semilinear parabolic interface problems is derived by using elliptic reconstruction technique introduced by Makridakis and Nochetto in (2003). A key idea for this technique is the use of error estimators derived for elliptic interface problems to obtain parabolic estimators that are of optimal order in space and time.
To create a highly efficient photovoltaic-thermal (PV-T) system and maximise the energy and exergy efficiency, this study aims to propose an innovative configuration of a PV-T system comprising wavy tubes with twisted-tape inserts. Following the validation of a numerical model, a parametric study has been conducted to assess the geometrical effects of twisted tape and wavy tubes, as well as the coolant fluid type and velocity, on the overall performance of a PV-T system, located in Shiraz, Iran. It is found that employing twisted tape improves the energy and exergy efficiency by approx. 6.3%. The best configuration yields 12.4% and 16.8% increase in energy and exergy efficiency compared to conventional PV systems. This is achieved at 15% vo
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