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 manufacturing industry in Iraq has faced, during the time stages, several obstacles that have had devastating effects on the Iraqi economy. These obstacles are represented by political events and wars that have led to the depletion of most human and material resources and the suspension of most vital industrial facilities from working, And the occurrence of this major deviation in the process of economic development, For the same reasons, the contributions of the manufacturing sector to the gross domestic product varied fluctuatingly, indicating instability in the growth rates of this sector, On the other hand, the supremacy of the belief that the dominance of oil resources as a main source for creating economic growth and achieving a h
... Show MoreThe new 4-[(7-chloro-2,1,3-benzoxadiazole)azo]-4,5-diphenyl imidazole (L) have been synthesized and characterized by micro elemental and thermal analyses as well as 1H.NMR, FT-IR, and UV-Vis spectroscopic techniques. (L) acts as a ligand coordinating with some metal ionsV(IV), Fe(III), Co(II), Ni(II), Cu(II), and Zn(II). Structures of the new compounds were characterized by elemental and thermal analyses as well as FT-IR and UV-Vis Spectra. The magnetic properties and electrical conductivities of metal complexes were also determined. Study of the nature of the complexes formed in ethanol following the mole ratio method.. The work also include a theoretical treatment of the formed complexes in the gas phase, this was done using the (hyperch
... Show MoreThe study aims at figuring out the intended meaning of intonation in some English conversational utterances together with identifying pitch variations that are determined by various syntactic constructions that impart the same illocutionary force of utterances. However, intonation is needed to delimit the communicative forces of utterances by virtue of its structure which the speakers intend to convey .This paper consists of four sections .Section one deals with phonology and its types .Section two discusses intonation in relation to style , forms and functions. Section three sheds some light on pragmatics. Section four deals in details with the intended meaning of intonation in some English conversational utterances. This paper comes up wi
... Show MoreIn this research, the region in the south-west of Iraq is classified using a fuzzy inference system to estimate its desertification degree. Three land cover indices are used which are the Normalized Difference Vegetation Index, Normalized Multi-Band Drought Index and the top of atmosphere surface temperature to build a fuzzy decision about the desertification degree using eight decision roles. The study covers a temporal period of 38 years, where about every 10 years a sample is elected to verify the desertification status of the region, starting from 1990 to 2018. The results show that the desertification status varied every 10 years, wherein 2000 encountered the highest desertification in the south-west of Iraq.
The study aimed to reveal the level to which the international issues are integrated into the books of Saudi public education social studies and citizenship in the light of the principles of international education, and to know the level of continuity and integration of these issues in the books, to build a range and sequence matrix of international issues through it. The study followed the descriptive and analytical method that used the content analysis card as a tool for study when the tool achieved the necessary validity and reliability characteristics. The data of this study has been processed using the SPSS statistical program according to a set of appropriate methods of descriptive and inferential statistics.
The resu
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The research aims to build an integrated frame of knowledge for the basic research topics, represented by (assimilation of knowledge, strategic clarity) and their basic variables, by examining the most important scientific propositions on these topics in administrative thought, and framing the knowledge contained in them, in a serious attempt to provide appropriate answers to questions The research dilemma, and the research was applied in the Iraqi Airways Company, whose number is (1200) employees, and the descriptive and analytical approach was adopted in conducting the research. A valid form for statistical analysis, i.e., with a retrieval rate of (92%). The two researchers used the (SPSS & AMOS) program for
... Show MoreIn this research we present An idea of setting up same split plots experiments in many locations and many periods by Latin Square Design. This cases represents a modest contribution in area of design and analysis of experiments. we had written (theoretically) the general plans, the mathematical models for these experiments, and finding the derivations of EMS for each component (source) of sources of variation of the analysis of variance tables which uses for the statistical analysis for these expirements
This study concerns a new type of heat exchangers, which is that of shell-and-double concentric tube heat exchangers. The case studies include both design calculations and performance calculations.
The new heat exchanger design was conducted according to Kern method. The volumetric flow rates were 3.6 m3/h and 7.63 m3/h for the hot oil and water respectively. The experimental parameters studied were: temperature, flow rate of hot oil, flow rate of cold water and pressure drop.
A comparison was made for the theoretical and experimental results and it was found that the percentage error for the hot oil outlet temperature was (- 1.6%). The percentage
... Show MoreThe study included the collection of 75 bronchial wash samples from patients suspected to have lung cancer. These samples were subjected to a diagnostic cytological study to detect the dominant type of lung cancer. It was noticed that 33 patients proved to have a lung cancer out of 75 (44%) of these, 19 cases (57.6%)were diagnosed having Squamus cell carcinoma,7cases (21.21%) showed Adenocarcinoma ,6 cases (18.18%) were having small cell carcinoma while only one case (3.03%)was large cell carcinoma .Nearly 70% of cases were correlated with smokers .Bacteria were isolated from 53 patients in which 33 isolates were associated with the cancer cases while 20 of them from non infected patients. By using different morphological ,biochemical test
... Show MoreSummary First: The importance of the study and the need for it: The society is composed of an integrated unit of groups and institutions that seek to achieve a specific goal within a system of salary, and the family remains the most influential institutions on the individual and the unity of society, with the roles and responsibilities of the individual and society, and through the continuation and strength of other social organizations derive their ability On the other hand, any break-up in the institution of the family is reflected negatively on the cohesion of society and its interdependence, and the causes of this disintegration vary from society to another, but family problems remain the main factor in obtaining it. Second: Study Ob
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