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 research aims to explain the References of receiving the explicit and implicit knowledge mentioned in the Noble Qur'an. The two researchers adopted the documentary and inductive approach to study the topic. Among the conclusions of the research: The Noble Qur'an dealt with many terms and concepts that refer to the References of making explicit knowledge available, including books, which were represented by the divine books (the Qur'an, the Torah, the Zabur and the Gospel) and their concepts (the book, the Qur'an, the guidance, the remembrance, the revelation, the light, the newspapers, the plates). He dealt with many concepts that refer to the References of providing tacit knowledge, which was represented by the communication between tw
... Show MoreThis work bases on encouraging a generous and conceivable estimation for modified an algorithm for vehicle travel times on a highway from the eliminated traffic information using set aside camera image groupings. The strategy for the assessment of vehicle travel times relies upon the distinctive verification of traffic state. The particular vehicle velocities are gotten from acknowledged vehicle positions in two persistent images by working out the distance covered all through elapsed past time doing mollification between the removed traffic flow data and cultivating a plan to unequivocally predict vehicle travel times. Erbil road data base is used to recognize road locales around road segments which are projected into the commended camera
... Show MoreDifferent frequency distributions models were fitted to the monthly data of raw water Turbidity at water treatment plants (WTPs) along Tigris River in Baghdad. Eight water treatment plants in Baghdad were selected, with raw water turbidity data for the period (2008-2014). The frequency distribution models used in this study are the Normal, Log-normal, Weibull, Exponential and two parameters Gamma type. The Kolmogorov-Smirnov test was used to evaluate the goodness of fit. The data for years (2008-2011) were used for building the models. The best fitted distributions were Log-Normal (LN) for Al-Karkh, Al-Wathbah, Al-Qadisiya, Al- Dawrah and, Al-Rashid WTPs. Gamma distribution fitted well for East Tigris and Al-Karamah WTPs. As for Al-
... Show MoreIn this paper, the density of state (DOS) at Fe metal contact to Titanium dioxide semiconductor (TiO2) has been studied and investigated using quantum consideration approaches. The study and calculations of (DOS) depended on the orientation and driving energies. was a function of TiO2 and Fe materials' refractive index and dielectric constant. Attention has focused on the effect of on the characteristic of (DOS), which increased with the increasing of refractive index and dielectric constant of Fe metal and vice versa. The results of (DOS) and its relation with and values of system have been discussed. As for contact system is increased, (DOS) values increased at first, but the relation is disturbed later and transforms into an inve
... Show MoreThis study aims to develop a recommendation engine methodology to enhance the model’s effectiveness and efficiency. The proposed model is commonly used to assign or propose a limited number of developers with the required skills and expertise to address and resolve a bug report. Managing collections within bug repositories is the responsibility of software engineers in addressing specific defects. Identifying the optimal allocation of personnel to activities is challenging when dealing with software defects, which necessitates a substantial workforce of developers. Analyzing new scientific methodologies to enhance comprehension of the results is the purpose of this analysis. Additionally, developer priorities were discussed, especially th
... Show MoreAccording to the prevalence of multidrug resistance bacteria, especially Pseudomonas aeruginosa, in which the essential mechanism of drug resistance is the ability to possess an efflux pump by which extrusion of antimicrobial agents usually occurs, this study aims to detect the presence of mexB multidrug efflux gene in some local isolates of this bacteria that show resistance towards three antibiotics, out of five. Sensitivity test to antibiotics was performed on all isolates by using meropenem (10μg/disc), imipenem (10μg/disc), amikacin (30 μg/disc), ciprofloxacin (5μg/disc) and ceftazidime (30 μg/disc). Conventional PCR results showed the presence of mexB gene (244bp) in four isolates out of ten (40%). In addition,25, 50μg/ml of cur
... Show MoreDevelopment of improved methods for the synthesis of metal oxide nanoparticles are of high priority for the advancement of material science and technology. Herein, the biosynthesis of ZnO using hydrahelix of beta vulgaris and the seed of abrus precatorius as an aqueaus extracts adduced respectivily as stablizer and reductant reagent. The support are characterized by spectroscopic methods ( Ft-IR, Uv-vis ).The FTIR confirmed the presence of ZnO band. The Uv-visible showed absorption peak at corresponds to the ZnO nanostructures. X-ray diffraction, scaning electron microscopy (SEM), dispersive X-ray spectroscopy (EDX) techniques are taken to investigation the size, structure and composition of synthesised ZnO nanocrystals. The XRD pattern mat
... Show MoreHeritage reflects peoples' memory and essence of nations. Thus, this divan was really the material and tool for writers in general and poets in specific both in their artificial innovations . Accordingly, modern writers have endeavored to bring heritage back in all its details and occurrences. Abdullwahab Al-Bayati's experience had reflected his innovative and strong link with the humanitarian heritage, in that heritage in view of Al-Bayati means both the humanitarian expertise and gains that are able to extend from past to future passing through the present.From this, the poet had not disconnected his strong link with the Arab poetic heritage .Thus, the poet had utilized the Arab poetic heritage in expressing on the Arab contrary realit
... Show MoreBackground: Health information systems in most countries are inadequate in providing the needed management support and the current health information systems are therefore widely seen as management obstacles rather than as tools,Objectives: the current study is an attempt to assess the behavioral and organizational determinants of health information system performance in Iraq.Methods: A cross-sectional study was conducted by interviewed a total of 189 respondents selected from six Iraqi governorates. The Organizational and Behavioral Assessment Tool was used to measure the behavioral and organizational determinants of health information system performance, it is one of the PRISM package tools that are used to assess the health informatio
... Show MoreThe human kidney is one of the most important organs in the human body; it performs many functions
and has a great impact on the work of the rest of the organs. Among the most important possible treatments is
dialysis, which works as an external artificial kidney, and several studies have worked to enhance the
mechanism of dialysate flow and improve the permeability of its membrane. This study introduces a new
numerical model based on previous research discussing the variations in the concentrations of sodium,
potassium, and urea in the extracellular area in the blood during hemodialysis. We simulated the differential
equations related to mass transfer diffusion and we developed the model in MATLAB Simu