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 higher education has become an enterprise integrate system that described as knowledge society, the essential part in its electronic and virtual format in the shadow of globalization challenges with its various dimensions . Until the logical ryles aboat a strategic partnership between the Iraqi higher education establishments and their international equivalent ones Strategic windows should be invested for the purpose of enhancing the quality of higher education in a sustainable way. This forms a challenge before the international education leaders on the social, operational and establishment's level to determinte knowledge gap, observing, diagnosing and processing in the present and future, e
... Show MoreANN modeling is used here to predict missing monthly precipitation data in one station of the eight weather stations network in Sulaimani Governorate. Eight models were developed, one for each station as for prediction. The accuracy of prediction obtain is excellent with correlation coefficients between the predicted and the measured values of monthly precipitation ranged from (90% to 97.2%). The eight ANN models are found after many trials for each station and those with the highest correlation coefficient were selected. All the ANN models are found to have a hyperbolic tangent and identity activation functions for the hidden and output layers respectively, with learning rate of (0.4) and momentum term of (0.9), but with different data
... Show MoreThe love of the world and its lusts are the head of sins and the corruptors of religion, and the one who loves and loves them who prefers them over the hereafter is one of the most pitiful of creation, and the least intelligent of them, as he prefers imagination over reality, sleep over wakefulness, fleeting shadow over eternal bliss and the mortal abode over the eternal abode, and he sold the life of eternity for the most luxurious life. In life, it is dreams and sleep or as a fleeting shadow, and as it was said: The intelligent person is not deceived.
The reason for choosing this topic is due to two things:
The first: When I contemplated the reasons for the differences and conflicts that afflicted our wounded and occupied country
This study aims to evaluate the performance of emergency departments according to international standards through studying the performance in some of Iraqi public hospitals, where the evaluation performance is considered one of the important topics that take a great deal of officials' attention, especially decision makers in health organizations.
The researcher has derived the research idea from the importance of work in emergency department in hospitals and to what it provides of medical services and quick and immediate nursing care that help in patients' lifesaving, and it is the mirror that reflects the real image for the hospital
... Show MoreIn this paper waste natural material (date seed) and polymer particles(UF) were used for investigation of removal dye of the potassium permanganate. Also study effect some variables such as pH, dye concentration and adsorbent concentration on dye removal. 15 experimental runs were done using the itemized conditions designed established on the Box-Wilson design employed to optimize dye removal. The optimum conditions for the dye removal were found: (pH) 12, (dye con.) 2.38 ppm, (adsorbant con.) 0.0816 gm for date seed with 95.22% removal and for UF (pH) 12, (dye con.) 18 ppm, (adsorbant con.) 0.2235 gm with 91.43%. The value of R-square was 85.47% for Date seed and (88.77%) for UF.
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A New Spectrophotometric Methods are improved for determination Metronidazole (MTZ) and Metronidazolebenzoate (MTZB) depending on1STand 2nd derivative spectrum of the two drugs by using ethanol as a solvent. Many techniques were proportionated with concentration (peak high to base line, peak to peak and peak area). The linearity of the methodsranged between(1-25µg.ml-1) is obtained. The results were precise and accurate throw RSD% were between (0.041-0.751%) and (0.0331-0.452%), Rec% values between (97.78, 101.87%) and (98.033-102.39%) while the LOD between (0.051-0.231 µg.ml-1) and (0.074-1.04 µg.ml-1) and LOQ between (0.170-0.770µg.ml-1) and (0.074-0.313 µg.ml-1) of (MTZ) and of (MTZB) respectively. These Methods were successfully ap
... Show MoreA character is one of the most important pillars of narrative production. Most critics believe that a character is the focus of events.
Jacob Steinberg, a Jewish writer who is Ukrainian by origin, wrote many stories, most of which spoke about the lives of Jews in the diaspora, especially in Ukraine. The environment there has been reflected in his stories.
Steinberg focused on the role of characters in shaping these productions.
In this study, we discuss the conflict of characters in Steinberg's stories. This conflict is characterized by different trends and goals. There is a conflict with the environment, a conflict with society, a conflict with the self,
... Show MoreData-driven models perform poorly on part-of-speech tagging problems with the square Hmong language, a low-resource corpus. This paper designs a weight evaluation function to reduce the influence of unknown words. It proposes an improved harmony search algorithm utilizing the roulette and local evaluation strategies for handling the square Hmong part-of-speech tagging problem. The experiment shows that the average accuracy of the proposed model is 6%, 8% more than HMM and BiLSTM-CRF models, respectively. Meanwhile, the average F1 of the proposed model is also 6%, 3% more than HMM and BiLSTM-CRF models, respectively.
Background: The beneficial gut bacterium E. coli can cause blood poisoning, diarrhoea, and other gastrointestinal and systemic disorders. Objective: This study amid to examines the antibiofilm activity of Laurus nobilis leaves extract on E. coli isolates and compares pre- and post-treatment gene expression of fimA and papC genes. Subjects and Methods: Ten isolates of E. coli were obtained from the Genetic Engineering and Biotechnology Institute, University of Baghdad, which was previously collected from Baghdad city hospitals and diagnosed by chemical tests, the diagnosis was confirmed using VITEK-2 System. The preparation of the aqueous and methanolic Laurus nobilis leaves extracts was done by using the maceration method and Soxhlet appara
... Show MoreABSTRACT This paper has a three-pronged objective: offering a unitary set of semantic distinctive features to the analysis of nominal “hatred synonyms” in the lexicon of both English and Standard Arabic (SA), applying it procedurally to test its scope of functionality crosslinguistically, and singling out the closest noun synonymous equivalents among the membership of the two sets in this particular lexical semantic field in both languages. The componential analysis and the matching procedures carried have been functional in identifying ten totally matching equivalents (i.e. at 55.6%), and eight partially matching ones (i.e. at %44.4%). This result shows that while total matching equivalences do exist in the translation of certain Eng
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