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.
Self-compacted concrete (SCC) considered as a revolution progress in concrete technology due to its ability for flowing through forms, fusion with reinforcement, compact itself by its weight without using vibrators and economic advantages. This research aims to assess the fresh properties of SCC and study their effect on its compressive strength using different grading zones and different fineness modulus (F.M) of fine aggregate. The fineness modulus used in this study was (2.73, 2.82,2.9& 3.12) for different zones of grading (zone I, zone II& marginal zone(between zone I&II)) according to Iraqi standards (I.Q.S No.45/1984).Twelve mixes were prepared, each mix were tested in fresh state with slump, V-Funnel and L-Box tests, then 72
... Show MoreObjective(s): The present study aims to evaluate the effectiveness of Health educational program on nurses' knowledge toward children pneumonia at Al-Amara City hospitals..
Methodology: A quasi –experimental study design two-study group (pretest-posttest 1 and posttest 2) carried out at Alzahrawy Hospital and Child and maternity hospital in Al Amara City to identify the effectiveness of the Health educational program on Nurses Knowledge toward Children pneumonia; the study was conducted between 1 of September 2019 to 1 of April 2020. A Purposive (Non-probability) sample is chosen for the present study. The size of sample is (60) nurses divided into two gr
... Show MoreThe internationalization of the Libyan crisis and its accompanying militarization of the conflict have played a vital role in hindering to reach a comprehensive political settlement solution in Libya. The increasing international greediness in the Libyan energy resources and the geopolitical importance of the Libyan State led to the involvement of many international and regional powers in this crisis and transformed the Libyan crisis into “proxy war”. Moreover, the Turkish direct military intervention in the Libyan crisis is considered as one of the main constraints facing the international and regional efforts to settle the Libyan crisis as a result of the Turkish insistence on its military existence in Libya to preserve i
... Show MoreThe Egyptian and Iraqi schools are one of the most important musical schools in the style of playing the oud. The influence of the style of these schools extended in the contemporary Arab world, and there were important names that emerged characterized with their style of playing. Thus, the ways of tuning the strings of oud varied between the two schools because of the difference in the ways of playing and the difference in the style of expression. The aim of the research was to identify the pluralism of the variable tunings of the strings of the contemporary Arab oud of the Egyptian and Iraqi schools, along the historical period extending from the late nineteenth and twentieth centuries to the present time. The oud has been classified i
... Show MoreThe concept of -closedness, a kind of covering property for topological spaces, has already been studied with meticulous care from different angles and via different approaches. In this paper, we continue the said investigation in terms of a different concept viz. grills. The deliberations in the article include certain characterizations and a few necessary conditions for the -closedness of a space, the latter conditions are also shown to be equivalent to -closedness in a - almost regular space. All these and the associated discussions and results are done with grills as the prime supporting tool.
Increasing world demand for renewable energy resources as wind energy was one of the goals behind research optimization of energy production from wind farms. Wake is one of the important phenomena in this field. This paper focuses on understanding the effect of angle of attack (α) on wake characteristics behind single horizontal axis wind turbines (HAWT). This was done by design three rotors different from each other in value of α used in the rotor design process. Values of α were (4.8˚,9.5˚,19˚). The numerical simulations were conducted using Ansys Workbench 19- Fluent code; the used turbulence model was (k-ω SST). The results showed that best value for extracted wind energy was at α=19˚, spread distance of wak
... Show MoreThe equation of Kepler is used to solve different problems associated with celestial mechanics and the dynamics of the orbit. It is an exact explanation for the movement of any two bodies in space under the effect of gravity. This equation represents the body in space in terms of polar coordinates; thus, it can also specify the time required for the body to complete its period along the orbit around another body. This paper is a review for previously published papers related to solve Kepler’s equation and eccentric anomaly. It aims to collect and assess changed iterative initial values for eccentric anomaly for forty previous years. Those initial values are tested to select the finest one based on the number of iterations, as well as the
... Show MoreAn image retrieval system is a computer system for browsing, looking and recovering pictures from a huge database of advanced pictures. The objective of Content-Based Image Retrieval (CBIR) methods is essentially to extract, from large (image) databases, a specified number of images similar in visual and semantic content to a so-called query image. The researchers were developing a new mechanism to retrieval systems which is mainly based on two procedures. The first procedure relies on extract the statistical feature of both original, traditional image by using the histogram and statistical characteristics (mean, standard deviation). The second procedure relies on the T-
... Show MoreTeaching through the system of personal learning, known as (Clare's plan) is amongst the most prominent plans which depend on self-education, as it received worldwide recognition. The plan lets the learner achieve learning by depending on himself after being familiar with the educational goals given to him, then he starts to solve the exercises and the drills accompanying the unit. After that, he checks his achievement by answering the self-evaluation tests. This method offers more opportunities for personal interaction than do the traditional systems, and individual leaning is a methodical expression aims at taking care of the learner and making him the locus of the processes of teaching and learning.
Aims of the study
... Show MoreThe study objective was to conduct Pharmacoeconomics study (cost-effective analysis) between infliximab reference (Remicade) and its biosimilar (Remsima) in patients with rheumatoid arthritis (RA) in Iraqi hospitals.
This is a retrospective multicenter pharmacoeconomic analysis conducted at two large teaching governmental hospitals in Baghdad, Iraq which provided infliximab to patients with RA. Data were collected from patient’s medical records and face-to-face interviews with the patients from December 2021 to April 2022.
The study included 57 patients with rheumatoid arthritis (RA). The patients were categorized into two groups according to the type of infliximab they received over 30 weeks: 27 patients received
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