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.
Fiber-to-the-Home (FTTH) has long been recognized as a technology that provides future proof bandwidth [1], but has generally been too expensive to implement on a wide scale. However, reductions in the cost of electro-optic components and improvements in the handling of fiber optics now make FTTH a cost effective solution in many situations. The transition to FTTH in the access network is also a benefit for both consumers and service providers because it opens up the near limitless capacity of the core long-haul network to the local user. In this paper individual passive optical components, transceivers, and fibers has been put together to form a complete FTTH network. Then the implementation of the under construction Baghdad/Al
... Show MoreThe lack of active 2019 coronavirus disease (COVID-19) pandemic treatment creates a challenge for researchers and scientists to find the most appropriate treatment for this disease. Dexamethasone, according to the findings of the RECOVERY clinical trial, declared mid-June 2020 in print media was one of those therapies. Although the results from retrospective studies are not strongly supportive of corticosteroid routine use in COVID-19 despite the signals for some benefits, the dedicated RECOVERY trial found a significant reduction in death with dexamethasone only in severe cases on a ventilator or moderate cases on supplemental oxygen therapy nevertheless, no benefit observed in mild to moderate cases requiring no oxygen. More studi
... Show MoreBetween the 1980s and 1990s, the HURIER model was developed by Brownell and consist of six interrelated components, which are represented in these acronyms (Hearing, Understanding, Remembering, Interpreting, Evaluating, and Responding). This model can be considered as a framework of the behavioral approach which can be used to improve students’ listening performance and to foster a positive attitude toward listening. Many learners find it challenging to improve their listening skills when learning a second or foreign language because it requires the integration of both listening and speaking. Consequently, enhancing this skill will help students improve other language skills, including reading, speaking, and writing. The HURI
... Show MoreBACKGROUND: Coronavirus current pandemic (COVID-19) is the striking subject worldwide hitting countries in an unexplained non-universal pattern. Bacillus Calmette–Guérin (BCG) vaccine was an adopted recent justification depending on its non-specific immune activation properties. Still the problem of post-vaccine short duration of protection needs to be solved. The same protective mechanism was identified in active or latent tuberculosis (TB). For each single patient of active TB, there are about nine cases of asymptomatic latent TB apparently normal individuals living within the community without restrictions carrying benefits of immune activation and involved in re-infection cycles in an excellent example of repeated immunity tr
... Show MoreVirtual organization is similar to traditional organization in principles, but is different in the ways it operates. It requires small creation costs compared to the traditional and it uses electronic commerce as the market place and distribution channel for its products and services.The aim of this article is to applying electronic commerce for a proposed virtual organization. The tools used to build an effective web application for virtual organization to provide virtual environment to the customers to do the transaction activities online include PHP, MySQL and Apache. HTML is used for displaying forms and tables and JavaScript is used for verification in client side. Finally, connecting it to 2Checkout.com company as a third party to per
... Show MoreThis study aims to examine how the lives of blacks are reduced and eliminated in Brother (2017) by David Chariandy. Black Lives Matter is a hash tag that appears after the killing of Trayvon Martin (17 years old African American) in 2012 by the savage hands of George Zimmerman (white person). This hash-tag has become a social movement that calls for equality in order to stop the violence against black people because their live is as valuable as white’s. The movement comes into being to highlight the “hypocritical democracy in service to the white males whose freedom are openly depended upon the oppression of blacks” (Lebron, 2017, P. 1). Those who have started this movement try to redeem a state and its arbitrary actions again
... Show MoreThe antimicrobial activity of two naphthoquinone semicarbazone derivatives (Two newly synthesized compounds) have been studied by using tube — diluation and disc plate technique. The effect of those derivatives upon pathogenic microorganism iso-lated from specimen(urine iwounds,stool, swabs, throat ....etc) have been studied also in comparison with the antibiotics (amikacin,ampicillin, carbencillin, cephalothin, cefoxitin,clindamycin ,erythromycin,gentamycin,penicillin,tetracylin and tri-methoprim. It was shown that derivative(1) had more effective against micro organ-ism than derivative(11).
