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.
Knowing the nature of the relationship in federal systems lies in studying the political, social, economic and cultural forces, for their role in laying the foundations and the federal system. No matter how important the pillars of that system are, and through this research, we will learn how the political elites were able to crystallize this unique system, until it became one of the political systems that some countries seek to copy and apply its experience.
The purpose of this study is to describe the extent and nature of informal tenure practices in urban areas in Iraq, through undertaking a rapid assessment in Baghdad city. The UN-HABITAT 2008 publication Secure Land Rights for All discusses the importance of access and rights to land throughout the developing world. Secure land rights are critical to development and poverty reduction, and the greatest challenge in providing secure land rights are in urban areas, where overcrowding can lead to a number of informal tenure practices ranging from individually unregistered or unauthorised housing, to large informal settlements. Access to land is a fundamental basis for human shelter, food production, and other economic activity. Secur
... Show MoreEase of transfer between different modes of public transportation within the stations is a significant contribution to the movement that can be provided by transportation industries to develop solutions of integrated transportation. It is future integrated multimodal transportation, to make public transportation more enjoyable and interesting, in addition to passenger transportation and future movement of goods are also depend on multimodal transportation The importance of interchange promotion between multimodal as a basic feature of passengers buildings in modern Railway Stations the Research problem:" con
... Show MoreThis research aims to identify the effectiveness of counseling by using the technique of self-talkin developing the habits of mind among middle school students by testing important hypotheses, and choosing the experimental design for the two groups (experimental - control). The classification of "Costa & Kallick" was adopted to measure the habits of the mind, and the scale consisted of (64) items, and after confirming the psychometric properties of the scale, the researcher applied it to the research sample (487) students from middle school students. One of the students who got the lowest marks after answering the scale. purpose of applying the experiment. He divided them into two groups, one of them is experimental (10) students, as
... Show MoreA mathematical model and associated computer program were developed to simulate the steady state operation of wiped film evaporators for the concentration of glycerol-water solution. In this model, various assumptions were made to facilitate the mathematical model of the wiped film evaporator. The fundamental phenomena described were: sensible heating of the solution and vaporization of water. Physical property data were coded into the computer program, which performs the calculations of this model. Randomly selected experiments were carried out in a small scale wiped film evaporator from ALVAL COMPANY, using different concentrations of the glycerol solution (10, 30 and 50 Wt. %) for different feed rates (30, 50, 80, 100 and 120 l/h) and
... Show MoreNew types of hydrodesulfurization (HDS) catalyst Re-Ni-Mo/ γ-Al2O3 was prepared and tested separately with two prepared conventional HDS catalysts (Ni-Mo/ γ-Al2O3 and Co-Mo//γ-Al2O3) by using a pilot plant hydrotreatment unit. Activities of three prepared hydrodesulfurization catalysts were examined in hydrodesulfurization (HDS) of atmospheric gas oil at different temperatures 275 to 350 °C and LHSV 1 to 4 h-1, the reactions conducted under constant pressure 40 bar and H2/HC ratio 500 ml/ml .Moreover, the hydrogenation of aromatic (HAD) in gas oil has been studied. HDS was much improved by adding promoter Re to the Ni-Mo/Al2O3 catalyst. The results showed that Re-Ni-Mo/ γ-Al2O3 have more activity in desulfurization than Ni-Mo//γ-Al2O3
... Show MoreThe flexibility of interaction between the movement of macroeconomic variables that affect and are affected by the balance of payments, especially the movement of the current account, implies a perception of the maturity of economic development and what the theory assumes from the launch of a wide range of economic movement that varies in the degree of its influence according to the level of economic development and the vitality of the internal/external overlap relations through the assumed response to the movement of the macroeconomic variables. On this basis, it is possible to estimate the soundness and rationality of the economic decision taken that takes into account the required reciprocal repercussions between the current a
... Show MoreThe research tagged (the image of the soldier in contemporary Iraqi painting) dealt with the concept of the image as one of the basic concepts in the creative achievement, whether it is in the field of art, literature or beauty. Therefore, the concept of the image expanded to express the various aspects of human creativity, including the field of painting. To know the image of the soldier in contemporary Iraqi painting, the research included four chapters. The first chapter focused on the methodological framework of the research, while the second chapter included three sections. The first topic dealt with the philosophical and artistic concept of the image. The second topic was concerned with the representations of the soldier's image in
... Show MoreThe City of Ember is a very interesting novel that is although intended for young readers, have so many layers and messages that are misunderstood. In this research, both the novel and the film adaptation are studied with the intent to decode the warning messages that the novelist and the director tried to introduce to the audience. The research studies four vital messages; the first message is that history repeats itself for the novel has many allusions to the history of Jews and their painful holocaust and even goes back in history the days of Moses and the Exodus, the second message tackles the conspiracy theory that states nothing happens by accident and that everything is planned and connected hence comes the third message
... Show MoreSeasonal variations of the species composition and abundance of Cladocera were studied in two stations at the end of the Tigris River and one station at the confluence of the Tigris with Euphrates area, at the beginning of the Shatt Al-Arab River in Al-Qurnah North of Basrah Province, from October 2015 to August 2016. Samples of zooplankton were collected by plankton net 100-µm. mesh size. The population density of Cladocera ranged between 1 Ind /m³ during summer and 211 Ind./m³ during winter at station 1 (Al-Jewaber Bridge). A total of 16 species of Cladocera belonging to 12 genera were recorded in the study. The average density of Cladocera ranged from 23.2 ind./m3 at Station 2 (Hamayon Bridge) to 53.7 Ind./m3
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