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.
Objective conditions for the possibility of punishment are legal or material facts –positive or negative that depart from the activity of the offender. The legislator comments on their subsequent verification on the formation of some crimes the possibility of.The application of punishment to the offender , but although they are facts of an object nature that approach and overlap with many systems and cases , they are distinguished by a certain subjectivity that differentiates them from each case that may seem similar or approach them. To clarify the ambiguity that may surround these conditions , Which may lead to confusion between them and what be similar to other cases due to the common effect that they have in common , which is the f
... Show MoreObjectives: To determine the effectiveness of post-abortion family planning counseling program on nurses and midwives' practices and to predict the variables which may effect on their practices Methodology: A quasi experimental study was conducted from 23th April 2017 to 14th March 2018 in three governorates in Middle Euphrates of Iraq: (Holy Karbala, Al - Najef Al Ashraf and Babylon) on nurses and midwives who work at maternity hospitals. Systematic random sampling was used to select 122 nurses and midwives, (60) of them for study group and (62) for control group. A checklist is an instrument that evaluate the practices which included 50 items. Validity of content was determined through reviewing it by (16) experts and reliability of to
... Show MoreThis research sheds light on the morphological structure of nouns and verbs in the novel "ASTONISHMENT" by the novelist Aharon Applefield by analysing selected models from the novel in a morphological analysis in order to identify the most important morphological features of this structure according to a statistical analytical approach.
The morphological structure is the main pillar of the linguistic structure of the literary text. Morphology is the science that studies the word, by which its structure and original letters are known, and the change that has occurred to it. The aesthetics of the fictional text is reflected in this structure, through which the writer conveys his ideas and narrations to the reader. The research
... Show MoreOver the years, the issue of inclusion of students with special educational needs (SEN) in mainstream schools is controversial worldwide. Evidence from research argues that without a positive teachers’ attitude towards the inclusion of students with SEN in mainstream schools, the successful implementation of inclusion is most likely doubtable. The aim of this paper is to understand teachers’ attitudes towards the inclusion of students with SEN in mainstream schools from different perspectives and from different contexts. The conclusion drawn in this review can be that teachers’ attitude is the most important key towards the appropriate inclusion implementation in mainstream schools. The disparity of teachers’ attitudes towards th
... Show MoreThe problem of generated waste as a result of the implementation of construction projects, has been aggravated recently because of construction activity experienced by the world, especially Iraq, which is going through a period of reconstruction, where construction waste represents (20-40%) of the total generated waste and has a negative effect on the environment and economic side of the project. In addition, the rate of consumpted amounts of natural resources are estimated to be about 40% in the construction industry, so it became necessary to reduce waste and to be manage well. This study aims to identify the key factors affecting waste management through the various phases of the project, and this is accom
... Show MoreThe marshes are one of the important environmental features affecting human and animal systems, so the studying of changes they undergo is one of the important topics. This study is concerned with the changes occurring in the Al Saadya marsh for the period from 1987 to 2017 exclusively in the winter season (the marshes’ revival season in Iraq revive). In order to inspect the changes in this marsh, we choose 7 years to cover the study period as a criterion years, namely 1987, 1990, 1995, 2000, 2007, 2014 and 2017. The “Maximum Likelihood” classifier was used to separate the stacked land cover features, where the minimum overall accuracy ratio that recorded for all years of study was 96%. The results revealed that Al-Saadya marsh went t
... Show MoreIn this paper the research introduces a new definition of a fuzzy normed space then the related concepts such as fuzzy continuous, convergence of sequence of fuzzy points and Cauchy sequence of fuzzy points are discussed in details.
The aim of this study was to provide an overall assessment to the efficiency of the Iraq stocks exchanges (ISE) through specifying well –known models .First, Fama's efficient market hypothesis as a contrary concept to the random walk hypothesis, was performed and it has been found that ISE follows the random process, so the price of the shares can't be predicated on the basis of past information. Second,we use a multifactor model, which so named multiple regression, to explore the link between ISE and the main economic indicators. our empirical analysis finds that every weak associations exists between major ISE measures and main economic indicators.
The size and the concentration of the gold nanoparticles (GNPs)
synthesized in double distilled deionized water (DDDW) have been
found to be affected by the laser energy and the number of pulses.
The absorption spectra of the nanoparticles DDDW, and the
surface plasmon resonance (SPR) peaks were measured, and found to
be located between (509 and 524)nm using the UV- Vis
spectrophotometer. SPR calculations, images of transmission
electron microscope, and dynamic light scattering (DLS) method
were used to determine the size of GNPs, which found to be ranged
between (3.5 and 27) nm. The concentrations of GNPs in colloidal
solutions found to be ranged between (37 and 142) ppm, and
measured by atomic absorptio
This paper describes a research effort that aims of developing solar models for housing suitable for the Arabian region since the Arabian Peninsula is excelled with very high levels of solar radiation.
The current paper is focused on achieving energy efficiency through utilizing solar energy and conserving energy. This task can be accomplished by implementation the major elements related to energy efficiency in housing design , such as embark on an optimum photovoltaic system orientation to maximize seize solar energy and produce solar electricity. All the precautions were taken to minimizing the consumption of solar energy for providing the suitable air-condition to the inhibitor of the solar house in addition to use of energy effici