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.
Stylistics represents a modern approach in understanding the literary text through the linguistic patterns that form it. The distinctive phenomena that the text includes constitute special features in it. As well as exploring its aesthetic aspects through description and analysis at the same time. The close link between stylistics and linguistics made stylistics occupy a prominent place in modern literary criticism.
In this regard, we do not want to dwell on the different directions of stylistics. Rather, we will prolong the discussion in the study of the style as a (deviation. Aversion) from the original. Because this trend plays on the chord of the paradox between the surface structure and the deep structure, especially when the sur
The research has been based on two main variables (information and communication technology) and the quality of blended education (physical and electronic), aiming to reveal the relationship between four dimensions (physical devices, software, databases, communication networks) and the elements of education represented by (the teacher, the student, the teaching process, curriculum). The methodology and post-analysis-based research were conducted at the Technical College of Management / Baghdad through polling the opinions of a random sample that included (80) teachers out of (86) and the number of students (276) representing a random sample from all departments of the college (for the morning study) out of (3500) stud
... Show More
The advertising mail is considered as one of potential tools that followed to transfer the printed messages to the consumers and public customers whom are located at homes or works. This type of advertising is preferable due to the zero expense to receive the announcements of products, which became recently one of the successful procedures to create new customers and keep them in touch with direct communication. It is also possible to send them to specific group of people who can be classified by the advertisers to select even by name their own clients to give the personality to the clients for a long term of communication.
&
... Show MoreBackground: Immediate implant placement in the maxillary anterior region was challenging, especially with the jumping gap and limited primary implant stability. Objective: To assess the autogenous dentin graft biomaterial's ability to improve the esthetic outcomes of an immediately inserted implant. Methods: Twenty patients with non-restorable retained roots in the maxillary non-molar region surrounded by natural sound teeth were included in this study after a complete clinical and radiological examination, including patient health and clinical fitness for the immediate dental implant procedure. A single dental implant was inserted for each patient, and the resulting jump distance was filled with the mineralized dentin graft and co
... Show MoreObjective: To measure the serum levels of Fetuin-A, ischemia-modified albumin (IMA), and ferritin in hospitalized patients with severe COVID-19in Baghdad, Iraq. Moreover, to determine these biomarkers' cut-off valuesthat differentiate between severely ill patients and control subjects. Methods: This case-control study was done from 15 September to the end of December 2021 and involved a review of the files and collectionof blood samples from patients (n=45, group1) hospitalized in COVID-19 treatment centersbecause of severe symptoms compared tohealthy subjects as controls (n=44, group2). Results: Fetuin-A serum levels were not statistically different between patients and controls. In contrast, IMA and ferritin levels were significan
... Show MoreA reliable and environmental analytical method was developed for the direct determination of tetracycline using flow injection analysis (FIA) and batch procedures with spectrophotometric detection. The developed method is based on the reaction between a chromogenic reagent (vanadium (III) solution) and tetracycline at room temperature and in a neutral medium, resulting in the formation of an intense brown product that shows maximum absorption at 395 nm. The analytical conditions were improved by the application of experimental design. The proposed method was successfully used to analyze samples of commercial medications and verified throughout the concentration ranges of 25–250 and 3–25 µg/mL for both FIA and batch procedures, respecti
... Show MoreA case–control study (80 patients with chronic hepatitis B virus [HBV] infection and 96 controls) was performed to evaluate the association of an IL12A gene variant (rs582537 A/C/G) with HBV infection. Allele G showed a signifcantly lower frequency in patients compared to controls (31.2 vs. 46.9%; probability [p]=0.009; corrected p [pc]=0.027) and was associated with a lower risk of HBV infection (odds ratio [OR]=0.49; 95% confdence interval [CI]=0.29–0.83). A similar lower risk was associated with genotypes CG (17.5 vs. 29.2; OR=0.25; 95% CI=0.08–0.81; p=0.02) and GG (10.0 vs. 16.7; OR=0.25; 95% CI=0.07–0.91; p=0.036), but the pc value was not signifcant (0.12 and 0.126, respec‑ tively). Serum IL35 levels showed signifcant difere
... Show MoreThe current research aims to determine the impact of the cognitive reconstruction program on the development of psychological hardness among middle school students through the experimental verification of three hypotheses. The research sample consisted of (16) out of (450) students selected from Ibn Rushud preparatory school- Al-Rusafa 2. These participants have been randomly distributed into two equal groups. The researcher has used the method of cognitive reconstruction with the experimental group, whereas with the controlling group, he used nothing. The researcher has further used the scale of psychological hardness of Kobassa with the participants; the scale has been built in a way that suits the sample of the study, which consisted
... Show More