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 persons who Allah Ioves them in the holly Quran
Objectivity Study0Dr 0muyad Turky Ali
Allah men tioned in Auran the loving of benevolent and who Allah loves him gave him everything 0the loving of benevolent came fist and after that the loving of justice who remove injustice and after that loving purified and in noeent 0After that mentioning loving of Knighters ( fighters )The eharity with money and to clear up the justice and loving purified is a reason of accessing paradise 0
The research deals with metaphors as being one of the primary means used by Lyudmila Ulitskaya when writing the novel " Sincerely Yours Shurik ", to form diverse and multifaceted collective female images of representatives of the classic psychological patterns presented in the work. This research reflects the results of the study related to the work of Lyudmila Yevkinevna Ulitskaya, an actress of modern Russian prose. The novel "The Sincerely to You Shorek" is one of Ludmila Ulitskaya's creations (the year of writing - 2003), which, like her other works, is distinguished by a unique presentation style, rich vocabulary, lexical and semantic diversity, and a special style of writing. writer. The main objective of the research is to look at th
... Show MoreHaruki Murakami (1949-present) is a contemporary Japanese writer whose works have been translated into fifty languages and won him plenty of Japanese and international awards. His short stories are well constructed in a weird realistic manner and are mixed with elements of surrealism. His novels and short stories fall under the genre of magical realism. One of the major revolving themes that Murakami wrote about was the haunting feeling of emptiness and disconnectedness in a world which seems to care much for materialism and self-interests.
The paper explores two of Murakami’s short stories in his book After the Quake (2000) and the relevance of their themes and characters to Iraq after the q
... Show MoreObjectives: To find out the effectiveness of education program application on nurses-midwives' knowledge toward prevention and management of postpartum hemorrhage in delivery room and some socio demographic characteristics Methodology: a quasi -experimental "test-retest"design has carried throughout the present study with the application of a pre –test and post- test for nurses-midwives' knowledge toward postpartum hemorrhage. The study was conducted in six hospitals in Baghdad: Fatima Al – Zahra for Maternity and Pediatric, Al -Elwia maternity, Baghdad Teaching, AL-Imamine Al - Kadhimin Teaching, Al-Karckh maternity and Al-Yarmouk Teaching hospital for the period from 27th May
... Show MoreThe purpose of the current work was to evaluate the effect of Radiation of Gamma on the superconducting characteristics of the compound PbBr2Ca1.9Sb0.1Cu3O8+δ utilizing a 137Cs source at doses of 10, 15, and 20MRad. Solid state reaction technology was used to prepare the samples. Before and after irradiation, X-ray diffraction (XRD) and superconductor properties were examined. Results indicated that the tetragonal structure of our chemical corresponds to the Pb-1223 phase with an increase in the ratio c/a as a result of gamma irradiation. (Tc (onset) ) and on set temperature Tc (offset)) were also dropping from 113 to the 85.6 K and 129.5 to 97 K, respectively, for a transition temperatu
Blastocystosis is symptomatic infection caused by the protozoal parasite Blastocystis , which resides in the intestinal tract of its hosts and it is one of the most common parasites reported in humans. It’s prevalence ranges between (30 - 50%) of the population in developing countries. This genus has a worldwide distribution and often the most commonly reported human intestinal protozoan in children and adults, even infect infants
Most countries in the world particularly developing countries, including Iraq, facing extremely dangerous problem with social and political dimensions, which is the emergence of the food crisis problem ,the decrease in domestic food production in Iraq isn't meet the needs of its population food, due to the fact that the agricultural sector suffers from multiple natural ,economic and human problems .It is still below the level required to meet the needs of the population of food ,since food at the forefront of priorities needed by the human . This represents indispensable basic necessity , so the responsibility of its availability permanently in appropriate&nb
... Show MoreUrban land uses are in a dynamic state that varies over time, the city of Karbala in Iraq has experienced functional changes over the past 100 years, as the city is characterized by the presence of significant tourist and socio-economic activity represented by religious tourism, and it occur due to various reasons such as urbanization. The purpose of this study is to apply a Markov model to analyze and predict the behavior of transforming the use of land in Karbala city over time. This can include the conversion of agricultural land, or other areas into residential, commercial, industrial land uses. The process of urbanization is typically driven by population growth, economic development, based on a set of probabilities and transitions bet
... Show MoreThe Small Indian Mongoose
Roller compacted concrete (RCC) is a material with no slumps and is made from the same raw materials as conventional concrete. The roller compacted dam method, the high paste technique, the corps of engineers method, and the maximum density method are all ways of designing RCC. The evolution of RCC has resulted in a substantial change in construction projects, most notably in dams, because of the sluggish pace of conventional placement, consolidation, and compacting. The construction process was accelerated by incorporating RCC into dams, resulting in a shorter construction period. Research shows that the dams that used RCC had completed one to two years sooner than the dams that used regular concrete (Bagheri an
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