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.
Gastroesophageal reflux disease (GERD) is a prevalent clinical condition, that affects millions of individuals worldwide. Objective: To assess the level of soluble HLA-E (sHLA-E) as a biomarker in the diagnosis and immunopathogenesis of GERD patients. Methods: The case-control prospective study included 40 GERD patients who were consulted at the Gastroenterology Unit of AlKindy Teaching Hospital, as along with 40 healthy control subjects. The study period extended from January 2023 to May 2024. Blood was drawn from both groups and serum was separated to assesssHLA-E using a sandwich enzyme-linked immunosorbent assay (ELISA) kit. Results: There was a statistically significant difference in sHLA-E levels between GERD patients and healthy cont
... Show MoreThe current research aims to identify the types and rates and the reasons for the crimes that are with the origin and sexual scattered deviation between the fabric of Iraqi society, which reticent about because of the culture of the community, where he offered a researcher investigator justice and tribal leaders and lawyers about proportion and the types and causes of crime is the origin of sexual deviance and finally a question asked a researcher in 1000 young lived their adolescence days of the former regime (1979-2003) from going to brothels researcher found that 920 people and 92% had gone to the house to practice adultery and that 70 of them, and by 7% had engaged in masturbation only and that 10 of them have not committed anything
... Show MoreThis study examines emotional blackmail from a discursive pragmatic standpoint to gain insights into how this psychologically manipulative phenomenon is revealed in the discourse of some American movies. Five extracts from five American movies are purposely selected and analyzed using an eclectic model based on a discursive pragmatic approach to navigate this unexplored study area. The model incorporates Halliday’s (2014) transitivity system, Martin and White’s (2005) attitude system, Forward and Frazier’s (1997) types and tools of emotional blackmail, and Mayfield’s (2010) informal fallacies. The present study is guided by four research questions that identify the types and tools of emotional blackmail employed in the selec
... Show MoreThe Internet of Things (IoT) technology is every object around us and it is used to connect these objects to the Internet to verify Machine to Machine (M2M) communication. The smart house system is the most important application of IoT technology; it is increase the quality of life and decrease the efforts. There were many problems that faced the existing smart house networking systems, including the high cost of implementation and upgrading, high power consumption, and supported limited features. Therefore, this paper presents the design and implementation of smart house network system (SHNS) using Raspberry Pi and Arduino platforms as network infrastructure with ZigBee technology as wireless communication. SHNS consists of two mai
... Show MoreThe conjunctive ''and'' and its Arabic counterpart ''و'' are discourse markers that express certain meanings and presuppose the presence of other elements in discourse. They are indispensable aids to both the text writers and readers. The present study aims to show that such cohesive ties help the writer to organize his main argument and communicate his ideas vividly and smoothly. They also serve as explicit signals that help readers unfold text and follow its threads as realized in the progression of context. The researcher has utilized the Quirk Model of Semantic Implication for data analysis. A total of 42 (22 for English and 20 for Arabic) political texts selected from different elite newspapers in both Arabic and English for the analy
... Show MoreReducing the drag force has become one of the most important concerns in the automotive industry. This study concentrated on reducing drag through use of some external modifications of passive flow control, such as vortex generators, rear under body diffuser slices and a rear wing spoiler. The study was performed at inlet velocity (V=10,20,30,40 m/s) which correspond to an incompressible car model length Reynolds numbers (Re=2.62×105, 5.23×105, 7.85×105 and 10.46×105), respectively and we studied their effect on the drag force. We also present a theoretical study finite volume method (FVM) of solvi
This paper deals with constructing mixed probability distribution from mixing exponential
Modern agriculture is challenged by soil degradation, nutrient depletion, plant diseases, and excessive dependence on chemical fertilizers and pesticides. By examining different strains of Pantoea, the study highlights their role in promoting plant growth, improving their tolerance to stress, reducing reliance on synthetic agricultural inputs, and contributing to more sustainable and environmentally friendly agricultural practices. Using a combination of practical qualitative methods and reliable quantitative data, the research gathers extensive information on how these microbes impact various crops and key soil health indicators. The improvements in plant growth statistics and nutrient levels are often quite astonishing. The result
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