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.
Transport is a problem and one of the most important mathematical methods that help in making the right decision for the transfer of goods from sources of supply to demand centers and the lowest possible costs, In this research, the mathematical model of the three-dimensional transport problem in which the transport of goods is not homogeneous was constructed. The simplex programming method was used to solve the problem of transporting the three food products (rice, oil, paste) from warehouses to the student areas in Baghdad, This model proved its efficiency in reducing the total transport costs of the three products. After the model was solved in (Winqsb) program, the results showed that the total cost of transportation is (269,
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Since its discovery in December 2019, corona virus was outbreak worldwide with very rapid rate, so it described by WHO as pandemic. It associated with severe acute respiratory distress syndrome, and can enter to cells through Angiotensin Converting Enzyme 2 (ACE 2) receptor which play an important role as regulator for blood pressure. Hypertension is a potential risk factor for sever acute respiratory syndrome COVID-19, and associated with high mortality rate as shown in many epidemiological studies. Moreover, specific antihypertensive medications that infected patients were receiving are not known; only data about renin-angiotensin-aldosterone system (RAAS) are available.
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Media has become a common platform for communication as a tool of offense. English language has many insult words which are commonly used in the world of media. This study investigates the socio-pragmatic aspect of insulting in English news. It aims at identifying and analysing insult words and expressions used by news presenters. To specify the problem of the study, language has a harmful power that hurts the addressees and seriously harm their psychological well-being. The insulting words that are an element of all human languages are the source of this abusive power. The study questions sought to find out are if news presenters use insult words, which insult words, and in what social contexts. In this study, the descriptive method is use
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Morphological and phonological studies of fungal pathogen infecting alfalfa weevil Hypera postica (Gyllenhal) indicating that infection has been shown to develop along two distinct physiological lines, each culminating in the production of either conidial or resting spores, in host cadavers which are morphologically distinct. The percent of infection and epizootic development appeared to be dependent on host density. Farther evidence to entail proper correlation between conidia and resting spores suggest that these two forms of spores are stages in the development of one pathogen.
This study aims to study argumentation in political debates by figuring out the logical fallacies employed in the debates of Clinton and Trump, the presidential nominees of the 2016 elections, and Biden and Trump, the leading contenders in the 2020 United States presidential election. The study attempts to answer the questions: (1) What relevance fallacies are adopted in the debate between Trump and Clinton? (2) What rhetorical devices are used to influence the audience and gain voters besides fallacies in the debates selected? The study analyses two texts from two arguments using Damer's (2009) taxonomy of relevance fallacy and rhetorical devices based on Perrine’s (1969) model of communication and interpersonal rhetoric to answe
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The evaluation of subsurface formations as applied to oil well drilling started around 50 years ago. Generally, the curent review articule includes all methods for coring, logging, testing, and sampling. Also the methods for deciphering logs and laboratory tests that are relevant to assessing formations beneath the surface, including a look at the fluids they contain are discussed. Casing is occasionally set in order to more precisely evaluate the formations; as a result, this procedure is also taken into account while evaluating the formations. The petrophysics of reservoir rocks is the branch of science interested in studying chemical and physical properties of permeable media and the components of reservoir rocks which are associated
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Polycystic ovary syndrome (PCOS) is a significant cause of infertility due to ovulation dysfunction in women of childbearing age. Although the pathogenesis of PCOS is still not clear, many studies have shown that many factors within the ovary promote infection. With this syndrome, the disruption of the natural monthly ovulation process causes an imbalance in the body's hormones, and the high level of insulin in the body and the blood sugar imbalance leads to the occurrence of hyperandrogenism, which is the main factor for the occurrence of pathogens, in addition to genetic factors, if any. This study aims to identify this disease and its most important causes, symptoms, and modern treatments to prevent and get rid of it. Polycystic
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