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.
Abstract
The research aims to determine the nature of the Iraqi market in terms of banking financial stability and the extent impact of the operational efficiency on it, Accordingly, chosen 15 relational banks were chosen as an intentional sample that could represent the Iraqi banking system for the period 2010-2020. The operational efficiency variable was measured according to the data envelope model, and banking financial stability used CAMELS model which includes five indicators (capital adequacy, asset quality, management quality, profitability, and liquidity), so for testing the research hypotheses used the random regression model by adopting the S
... Show MoreThis work is devoted to a comparative study of the phenomenon of enantiosemy in Russian and Arabic.Everyone knows the term antonyms - words of the same part of speech, opposite in meaning, such as: Day and night, white and black, truth and lies. But in Russian, Arabic and other languages there is an interesting phenomenon, which consists in the fact that one word has two opposite meanings. Such a phenomenon in linguistics is called enantiosemy (from the Greek words enantios - "opposite" and sema - "sign")
The current study aims to overcome the conflicts facing the company in its way of staying and continuing to maintain its performance excellent in light of the intense competition, which made it seek to find strong ways and links with its customers through electronic communication using electronic platforms, and this put confidence and safety in The place of suspicion and fear of not fulfilling credibility or violating the privacy, so this research comes to answer about the question: “Can the company achieve an excellent performance by relying on the customer's electronic confidence?”.
The study followed the descriptive and analytical approaches by providing a virtual model and testing the zero hypotheses, which stipulat
... Show MoreBackground: Lymphomas are a group of diseases caused by malignant lymphocytes that accumulate in lymph nodes and cause the characteristic clinical features of lymphadenopathy. Intercellular adhesion molecule-1 (ICAM-1) (CD54) is a transmembrane glycoprotein belonging to the immunoglobulin superfamily of adhesion molecules. Cortactin was first identified as one of the major substrates for src kinase. because it localized to Cortical actin structures, The aims of this study was to evaluate and compare the immunohistochemical of ICAM-1 expression as cell adhesion molecule marker and Cortactin expression as invasive marker. Material and Methods: This study was performed on (68) formalin-fixed, paraffin-embedded blocks, histopathologically diagn
... Show MoreThis research aims to find out the impact on the receptive style according to the specimen in the collection of material Brawner and retention as students at the Arabic Department at the Faculty of Education for Girls. For confirmation from the goal of the research, the researcher placed two hypotheses, one to two for collections and one for pods. - chosen as the College of Education for Girls / Department of Arabic language for the application of choice Intentionally search experience for reasons of researcher he is teaching them and thus ensures cooperation of teachers and students in them. - selected Division (b) of the fourth grade students of the Arabic language section at random to represent the experimental group, while the Division
... Show MoreGastritis can be defined as histological inflammation of the gastric mucosa. It can be classified according to the time course of the disease as acute or chronic, histological findings, anatomic location, and pathological mechanisms. The objective of this study was to evaluation of serum levels of the proinflammatory cytokines IL-8, IL-17 and IL-22 in Helicobacter pylori infection and their association with the degree of gastritis histopathology in a sample of Iraqi patients. The case-control prospective study consists of 60 patients who attended the Gastrointestinal Tract Center at Al-Kindy Teaching Hospital during the period from December 2019 to April 2020. In addition, the control group included 60 apparently healthy individuals. Bio
... Show MoreBackground: Intramedullary astrocytomas
account for about 1% of all CNS tumors and
6–8% of spinal cord tumors. The vast majority
of intramedullary astrocytomas are slowgrowing
lesions.
Objectives: The goal in this study was to
review a series of patients who underwent
surgical removal of intramedullary high-grade
astrocytomas, focusing on the functional
outcome and the effect of multimodality
treatment on the survival of patients with high
grade intramedullary astrocytoma.
Methods: Between June 1999 and June 2004,
22 patients underwent removal of
intramedullary high-grade astrocytomas in four
neurosurgical hospital in Baghdad/ Iraq
(Neurosurgical hospital, Al Shaheed Adnan
Hospital for
This study addresses the issue of academic writing in English by comparing pragmatic argumentation in the writing of 40 graduate students studying at Iraqi universities (SSIU) with the writing of 40 graduate students studying at American universities (SSAU). In these 80 theses, six selected aspects of academic writing were analyzed: (a) paragraph structure, (b) length and construction of sentences, (c) organization of information in sentences, (d) vocabulary, (e) topic sentences, and (f) discourse markers. This study seeks to go beyond the traditional and often onedimensional analysis of pragmatics of argumentation in English academic writing to distinguish and describe different aspects of academic writing and their results when used by EF
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