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 research deals with the lyrical introduction in the commentary of Tarfa bin al-Abd as a formative system characterized by flexibility and richness of imagination, which achieved a formative treatment and a unique construction within the structures of the structural and semantic language. I dealt with the poetic verses represented by the lyrical introduction as a formative hypothesis, basing its goal on a methodological framework distributed on the problem that was summarized by the following question: Is it possible to look at the poetic pattern within the pre-Islamic poem / hanging blinking as a model, in its plastic dimensions and to identify the stylistic treatment that achieves the formation space within the poetic text. The rese
... Show MoreThis paper presents a three-dimensional Dynamic analysis of a rockfill dam with different foundation depths by considering the dam connection with both the reservoir bed and water. ANSYS was used to develop the three-dimensional Finite Element (FE) model of the rockfill dam. The essential objective of this study is the discussion of the effects of different foundation depths on the Dynamic behaviour of an embanked dam. Four foundation depths were investigated. They are the dam without foundation (fixed base), and three different depths of the foundation. Taking into consideration the changing of upstream water level, the empty, minimum, and maximum water levels, the results of the three-dimensional F
This study relates to the estimation of a simultaneous equations system for the Tobit model where the dependent variables ( ) are limited, and this will affect the method to choose the good estimator. So, we will use new estimations methods different from the classical methods, which if used in such a case, will produce biased and inconsistent estimators which is (Nelson-Olson) method and Two- Stage limited dependent variables(2SLDV) method to get of estimators that hold characteristics the good estimator .
That is , parameters will be estim
... Show MoreEconomic organizations operate in a dynamic environment, which necessitates the use of quantitative techniques to make their decisions. Here, the role of forecasting production plans emerges. So, this study aims to the analysis of the results of applying forecasting methods to production plans for the past years, in the Diyala State Company for Electrical Industries.
The Diyala State Company for Electrical Industries was chosen as a field of research for its role in providing distinguished products as well as the development and growth of its products and quality, and because it produces many products, and the study period was limited to ten years, from 2010 to 2019. This study used the descriptive approa
... Show MoreBackground: The purpose of this study was to evaluate and compare centering ability and canal transportation of simulated S-shaped canals instrumented with four different types of rotary nickel-titanium systems. Materials and Methods: Forty simulated S-shaped canals in resin blocks were divided into four groups of ten each and were instrumented to an apical size 25 by different instrumentation technique using ProTaper Universal files (group A), ProTaperNext (group B), Reciproc (group C) and WaveOne (group D).Centering ability and canal transportation was measured at (11) measuring points from D0 to D10 bysuperimposion of the pre- and post-operative images obtained by using digital camera in standardized manner. An assessment of the canals
... Show MoreBreast cancer is a disease in which cells in the breast grow out of control. CD200 is a cell surface glycoprotein expressed on many cells, it belongs to the immunoglobulin family (Ig) and have a great role in the regulation of inflammation in autoimmunity. CD200 is the ligand for CD200R1 receptor. To determine if serum level of CD200 and its receptor CD200R1 can be used as a diagnostic and prognostic marker in patients with breast cancer.This case control study was carried out at Oncology Teaching Hospital – Medical city in Baghdad. Six groups were enrolled, four groups were confirmed with breast cancer stage (I, II, III and IV), fifth group (benign) and sixth group was control (healthy individual). Serum is divided to me
... Show MoreBroadcasting across satellites has become an important media phenomenon and largely available for watchers. As the receiver can see the events at the very moment and at any spot in the world. This study aims to discover the degree of the extent of exposure of Iraqi people to the news broadcasting satellites in Arabic language, (Al Jazeera, Al Arabiya, Al Ekhbariya Satellite Channels) as one of the media that serves the public; and to discover the range of these Satellite Channels in covering the local Iraqi situation in different sides and aspects; and to know the significance of the Iraqi people in watching those news programmers; and state the motives behind the Iraqi public's dependence on these channels.
The
... Show MoreToxoplasma gondiiis an obligate intracellular protozoan parasite of the phylum Apicomplexa, and toxoplasmosis is an important disease of both humans and economically important animals. With a limited array of drugs available there is a need to identify new therapeutic compounds. Aureobasidin A (AbA) is an antifungal that targets the essential inositol phosphorylceramide (IPC, sphingolipid) synthase in pathogenic fungi. This natural cyclic depsipeptide also inhibits