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 developments in forensic DNA technology have led us to perform this study in Iraqi population as reference database of autosomal Short Tandem Repeat (aSTR) DNA markers . A total of 120 unrelated individuals from Wasit province were analyzed at 15 STR DNA markers. Allele frequencies of DNA typing loci included in the AmpFlSTR1 IdentifilerTM PCR Amplification Kit panel from Applied Biosystems (D3S1358, vWA, FGA, D8S1179, D21S11, D18S51, D5S818, D13S317, D7S820, TH01, TPOX, CSF1PO, D19S433, D2S1338, D16S539) and several forensic efficiency statistical parameters were estimated from all the sample. the combined Matching Probability (CMP) using the 15 STR genetic loci in Iraqi population was estimated at 1 in 2.08286E-18 and the Combined
... Show MorePhonological metathesis can be defined as an alternation in the normal sequence of two sounds under certain conditions. The present paper is intended to give a detailed synchronic description of phonological metathesis in Iraqi Arabic dialect. For data collection, the researchers have adopted two naturalistic techniques, viz., observation and notes taking. A synchronic analysis is carried out to provide some evidence that describe the sequential change of phonological metathesis in the dialect under investigation. Such sequential changes of metathesized sounds are presented and tabulated. The study concludes with the following finding that this process is not limited to cases where two consonant sounds are transposed, but three consonant
... Show MoreIn this paper, there are two main objectives. The first objective is to study the relationship between the density property and some modules in detail, for instance; semisimple and divisible modules. The Addition complement has a good relationship with the density property of the modules as this importance is highlighted by any submodule N of M has an addition complement with Rad(M)=0. The second objective is to clarify the relationship between the density property and the essential submodules with some examples. As an example of this relationship, we studied the torsion-free module and its relationship with the essential submodules in module M.
The purpose of this paper is to statistically classify and categorize Building Information Modelling (BIM)-Facility Management (FM) publications in order to extract useful information related to the adoption and use of BIM in FM.
This study employs a quantitative approach using science mapping techniques to examine BIM-FM publications using Web of Science (WOS) database for the period between 2000 and April 2018.
The findi
Spinal dysraphism is the incomplete fusion of the neural arch, which can be seen as an occult or open neural tube defect. Meningoceles are a form of open neural tube defect characterized by cystic dilatation of the meninges containing cerebrospinal fluid without the involvement of neural tissue. Neurosurgical intervention is necessary in the newborn period since survival in advancing ages is often impossible. Therefore, meningoceles are rarely reported in adulthood. Here, we discussed a case of a 23-year-old female who presented with a meningocele in the lumbosacral area since birth, which had not been operated on. Surgical management and intraoperative findings are also discussed.
When scheduling rules become incapable to tackle the presence of a variety of unexpected disruptions frequently occurred in manufacturing systems, it is necessary to develop a reactive schedule which can absorb the effects of such disruptions. Such responding requires efficient strategies, policies, and methods to controlling production & maintaining high shop performance. This can be achieved through rescheduling task which defined as an essential operating function to efficiently tackle and response to uncertainties and unexpected events. The framework proposed in this study consists of rescheduling approaches, strategies, policies, and techniques, which represents a guideline for most manufacturing companies operatin
... Show MoreBioaccumulation of heavy metals in the terrestrial invertebrates in Al-Jadriyia district Baghdad- Iraq were investigated. Forth terrestrial invertebrates snails, slug, isopods, and diplopods , were selected for this study. The results showed that all invertebrate groups have the ability in accumulate considerable amounts of heavy metals. Higher levels of zinc and copper were observed in the isopods specimens, it's about ( 60.50±0.58 ) and ( 96.00±0.58 ) ppm respectively , while higher levels of lead were observed in the diplopods specimens ,it's about ( 23.00±1.15 ) ppm ,but the higher levels of both iron and cadmium were observed in snail specimens , it's about ( 590.00±1.15 ) and ( 9.50±1.15 ) ppm respectively .but the
... Show MoreThe study aims to build a water quality index that fits the Iraqi aquatic systems and reflects the environmental reality of Iraqi water. The developed Iraqi Water Quality Index (IQWQI) includes physical and chemical components. To build the IQWQI, Delphi method was used to communicate with local and global experts in water quality indices for their opinion regarding the best and most important parameter we can use in building the index and the established weight of each parameter. From the data obtained in this study, 70% were used for building the model and 30% for evaluating the model. Multiple scenarios were applied to the model inputs to study the effects of increasing parameters. The model was built 4 by 4 until it reached 17 parame
... Show MoreThe electric submersible pump, also known as ESP, is a highly effective artificial lift method widely used in the oil industry due to its ability to deliver higher production rates compared to other artificial lift methods. In principle, ESP is a multistage centrifugal pump that converts kinetic energy into dynamic hydraulic pressure necessary to lift fluids at a higher rate with lower bottomhole pressure, especially in oil wells under certain bottomhole condition fluid, and reservoir characteristics. However, several factors and challenges can complicate the completion and optimum development of ESP deployed wells, which need to be addressed to optimize its performance by maximizing efficiency and minimizing costs and uncertainties. To
... Show More