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.
In recent years, the linguo-philosophical studies of metaphor have tended to define metaphor as an interaction of the object, that is the referent of conceptualization and some features that are associated with sensual manner realities, whose name is used when resolving the conceptual problem-nominative situation, namely the situation of the formation of a new concept and its verbalization. The objective of this term paper lies in the phenomenon of metaphors used in modern political discourse. In our understanding a metaphor is not only of a linguistic nature, but also political. This paper approaches the subject of conceptual metaphor and political argumentation through the prism of synergies of the political topic, affirmative or negative
... Show Moreالنظام السياسي اليمني : دراسة في المتغيرات الداخلية
Background: Osteoid osteoma(OO) is a relatively common benign skeletal neoplasm of unknown etiology that is composed of osteoid and woven bone, usually seen in adolescent and young males Although, the clinical, radiological and scintigraphic features of OO have been well described, these features may be misleading or altered in the cases of lesser trochanter of the femur which is relatively uncommon location for OO with a few number of cases reported up to date. Case Presentation: We report a case of a 20-year-old man who presented with painful limpThe pain had begun six months earlier and was made worse by walking and by exercise., with normal initial X-rays .The diagnosis was made after six months when typical Computed tomography, magneti
... Show MoreGiven a matrix, the Consecutive Ones Submatrix (C1S) problem which aims to find the permutation of columns that maximizes the number of columns having together only one block of consecutive ones in each row is considered here. A heuristic approach will be suggested to solve the problem. Also, the Consecutive Blocks Minimization (CBM) problem which is related to the consecutive ones submatrix will be considered. The new procedure is proposed to improve the column insertion approach. Then real world and random matrices from the set covering problem will be evaluated and computational results will be highlighted.
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Presentation of urinary calculus ranges from painful urination to acute retention. Diagnosed by x-ray pelvis and non-contrast CT and removal of stone by various methods is the management. Variety in symptoms, sometimes make clinical diagnosis difficult until radiological investigations confirm it. In this case presentation, initial diagnosis was made of Urethrocutaneous fistula may be due to distal stricture, but on investigating, he was diagnosed as urethral calculus in urethral diverticulum , as the reason for his symptoms
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Background: Diabetic cheiroarthropathy is a term derived from the Greek word “cheiros” meaning “of the hand”, It is characterized by stiff hands with distinctively thick, tight, and waxy skin, especially on the dorsal aspects of the hands. It is part of long term complication of diabetes and many suggest it is associated with microvascular complication. The aim of the study was to determine the prevalence of diabetic cheiroarthropathy in Iraqi patients with diabetes, and to study its association with diabetic retinopathy and glycemic control. Material and Methods: A cross-sectional study in which 110 diabetic patients and 110 non-diabetic healthy people who accepted to take part in the study were ran
... Show MoreZiziphora persica Bunge is recorded as a new Study in Iraq. This species has been collected from Jabal Sinjar in Nineveh province in the north western part of Iraq. The morphological characters, habitat and geographical distribution of the species with a key to Ziziphora L. species in Iraq have been provided.
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
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