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 article considers metaphors as one of the fundamental means used by L. Ulitskaya when writing the family chronicle "Medea and her Children" (1996), for the formation of images of heroines - representatives of the pronounced feminine principle in the work. Here I describe the results of the next stage of research related to the work of Lyudmila Evgenievna Ulitskaya as a representative of modern Russian prose.
Haruki 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 MoreThe current research deals with the dialectical relationship resulting from the conflict in the violent combination and construction of the living ( the actor)and the dead (the item) in the structure of the Sinography construction and the emergence of the theatrical play space , which can be summed up by the following question: what is the nature of the dialectical relationship between the living (the actor) and the dead( the item) in the Sinography creation, which limited the research in a central objective : to identify the controversy of the living (actor) and the dead (item) in the performance unit of the theatrical scene . The research, in its objective limits set forth in its methodological framework, analyzes this controversy in o
... Show MoreArt education is one among the fundamental subjects for elementary school students, because it contributes to assembling learners’ personalities and developing their technical skills. For this reason, this research comes, which aims to understand the effect of the task groups’ strategy in developing the performance of elementary school students in art education. to realize the goal of the research, the researcher put the subsequent hypotheses:
-There is not any statistically significant difference at the amount (5%) between the typical many students between the experimental group that studied consistent with the strategy of task groups and therefore the control group that studied in keeping with the same old method that they obt
Objectives: 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 extraction of Basil oil from Iraqi Ocimum basillicum leaves using n-hexane and petroleum ether as organic solvents were studied and compared. The concentration of oil has been determined in a variety of extraction temperatures and agitation speed. The solvent to solid ratio effect has been studied in order to evaluate the concentration of Ocimum basillicum oil. The optimum experimental conditions for the oil extraction were established as follows: n-hexane as organic solvent, 60 °C extraction temperature, 300 rpm agitation speed and 40:1mL:g amount of solvent to solid ratio.
It is well known that the rate of penetration is a key function for drilling engineers since it is directly related to the final well cost, thus reducing the non-productive time is a target of interest for all oil companies by optimizing the drilling processes or drilling parameters. These drilling parameters include mechanical (RPM, WOB, flow rate, SPP, torque and hook load) and travel transit time. The big challenge prediction is the complex interconnection between the drilling parameters so artificial intelligence techniques have been conducted in this study to predict ROP using operational drilling parameters and formation characteristics. In the current study, three AI techniques have been used which are neural network, fuzzy i
... Show MoreThe Small Indian Mongoose
The paper contains a theoretical analysis of the interrelation between methodology of economics used by economic researchers and the methodology of scientific research, encouraging readers to think differently about one of the most complicated & controversial subjects.
The analysis begins with the determination of propositions that were discussed and explained in the course of the argument.
1- The economic researcher, like a scientific one, goes after the procedures of physical sciences and benefits of the forms of logic.
2- Economics deals with human behavior while the natural sciences deal with the matter.
3-This similarity a
... Show MoreMammals are under threat worldwide due to deforestation, hunting, and other human activities. In Iraq, a total of 93 species of wild mammals have been recorded including species with global conservation concern. Bamo Mountain is situated within the Zagros Mountains in northern Iraq which is a suitable habitat for wild mammals. Due to scarcity of the field survey efforts and cryptic behavior, monitoring of the wild mammals fauna in Zagros Mountain seems challenging. Therefore, we used a camera trap which seems to be an ideal way to determine species diversity of wild mammals in Bamo Mountain. Moreover, interviews with local villagers were performed. The mammalian diversity of Bamo Mountain is not fully explored but seemed threatened by lo
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