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.
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The way artists deal with body in their artistic works has had so many forms and methods, whether as an object for their drawings or as a material to create live artistic performances that relate to the idea of correspondence and interaction between different artistic categories such as: drama, dance, and painting as it is the case of the artist Marina Abramovic who has always used her body as an artistic unit to generate meaning and to perform her lively shows.
To go deeper into her career, our work was divided into 3 sections:
The first section was devoted to follow the main artistic stages that her body had gone through, starting with paintings she performed using concepts based on acting, simulation and nudity and ending wi
Because of its importance in the world, Middle East area is one of the competition areas between the major and great powers. Among those powers are Russia and United states of America. The competition between these two powers to control Syria is greatly clear since 2011. It is also one of the most important subject in the international politics. This importance comes from the importance of Russia and the United States of America besides importance of the Middle East. At the end of the cold war, United States of America maintained its role in the international system and became the only pole that dominated the international affairs while Russia tried to overcome the challenges inherited from the former Soviet Union, and it succeeded in th
... Show MoreTigris River is the lifeline that supplies a great part of Iraq with water from north to south. Throughout its entire length, the river is battered by various types of pollutants such as wastewater effluents from municipal, industrial, agricultural activities, and others. Hence, the water quality assessment of the Tigris River is crucial in ensuring that appropriate and adequate measures are taken to save the river from as much pollution as possible. In this study, six water treatment plants (WTPs) situated on the two-banks of the Tigris within Baghdad City were Al Karkh; Sharq Dijla; Al Wathba; Al Karama; Al Doura, and Al Wahda from northern Baghdad to its south, that selected to determine the removal efficiency of turbidity and
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... Show MoreWith the increasing reliance on microgrids as flexible and sustainable solutions for energy distribution, securing decentralized electricity grids requires robust cybersecurity strategies tailored to microgrid-specific vulnerabilities. The research paper focuses on enhancing detection capabilities and response times in the face of coordinated cyber threats in microgrid systems by implementing advanced technologies, thereby supporting decentralized operations while maintaining robust system performance in the presence of attacks. It utilizes advanced power engineering techniques to strengthen cybersecurity in modern power grids. A real-world CPS testbed was utilized to simulate the smart grid environment and analyze the impact of cyberattack
... Show MoreThe idea of a homomorphism of a cubic set of a KU-semigroup is studied and the concept of the product between two cubic sets is defined. And then, a new cubic bipolar fuzzy set in this structure is discussed, and some important results are achieved. Also, the product of cubic subsets is discussed and some theorems are proved.
Increasing requests for modified and personalized pharmaceutics and medical materials makes the implementation of additive manufacturing increased rapidly in recent years. 3D printing has been involved numerous advantages in case of reduction in waste, flexibility in the design, and minimizing the high cost of intended products for bulk production of. Several of 3D printing technologies have been developed to fabricate novel solid dosage forms, including selective laser sintering, binder deposition, stereolithography, inkjet printing, extrusion-based printing, and fused deposition modeling. The selection of 3D printing techniques depends on their compatibility with the printed drug products. This review intent to provide a perspecti
... Show MoreIs no longer a football player looks to sport as a means of entertainment and physical development. But become see as part of The economic and is getting in return for the effort of، Through a contract with a club to organize the activity which is called a contract of professional, This contract is similar to the rest of the contracts in terms of problems and dispute that arise during the implementation or after it ends because of the nature of sports to such disputes and privacy being subject to special rules (regulations, national and international professional) required that subject to judicial bodies private mission confined settle sports disputes these entities and is affiliated unions legal committees and the court of arbitration for
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