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.
This study aims at discussing how gender differences might affect communication among people. For this purpose, several TV interviews are selected and examined on the discourse level. Developing a model of analysis ,is found that certain linguistics have been used by male speakers ,whereas different aspects have been utilized my female speakers like deictic expressions and lexical items of emotion and delicacy .
Bee keping projects is one of the most important agricltural investment projects because it generate profit in a short period . In addition to the multiplicity of products and other benefits . Research aimed at study the feasibility of two projects one hand in the origin of the Al – Mashrok since 2006 , kicking off with ten hives , and the scond proposal , kicking of 100 hives using the criteria of the world bank . Results showed that the bee keeping projects is economically feasible, whether small or large .. Even when the analysis of the sensitivity of the project to changes which may occur in the price of output and resources by reducing costs and increasing revenues by 10% it remains economically viable .
... Show MoreThe present study aims to remove nickel ions from solution of the simulated wastewater using (Laminaria saccharina) algae as a biosorbent material. Effects of experimental parameters such as temperature at (20 - 40) C⁰, pH at (3 - 7) at time (10 - 120) min on the removal efficiency were studied.
Box-Wilson method was adopted to obtain a relationship between the above three experimental parameters and removal percentage of the nickel ions. The experimental data were fitted to second order polynomial model, and the optimum conditions for the removal process of nickel ions were obtained.
The highest removal percentage of nickel ions obtained was 98.8 %, at best operating conditions (Temperature 35 C⁰, pH 5 and Time 10 min).
The objective review is to inspect the involvement of Interleukin-6 (IL-6) in rheumatoid arthritis (RA) and to highlight the role of IL-6 and its variants in the pathogenesis of RA and response to anti-IL-6 agents. Several genetic and environmental risk factors and infectious agents contributed to the development of RA. Interleukin-6 is engaged in self-targeted immunity by modifying the equilibrium between T regulatory (T-reg) and T helper-17 (Th-17) cells. The evidences reported that IL-6 parti
The study aimed to monitor the concept of reputation in the previous literature, its relationship to mental image and identity, and to reveal recent trends in its measurement Techniques.
The study relied on a descriptive approach using library survey and comparative analysis, and the study reached following conclusions:
Despite the beginning of the first signs of reputation In the fifties of the last century, however, Defining and standardizing the concept with clear and specific dimensions began in the 1990s and the beginning of the third millennium. The concept of reputation refers to the stakeholders’ overall evaluation of organizations, which reflects their perceptions of
... Show MoreTheoretical trends have appeared Which posed the concept of biological structures in contemporary architecture concept, Spread through the emergence of architectural production that reflect and indicate the nature of the construction structures based on the ideas and principles of biological structures in biological science: Despite the emergence of many architectural proposals that tried to explain the concept in the field of architecture, but it is not dealt with in depth and not given a comprehensive definition: So there was need to search for the concept and its beginning in the biological field as a general framework down to the field of architecture for the purpose of reducing the limits of their search framework T
... Show MoreThe aerodynamic characteristics of general three-dimensional rectangular wings are considered using non-linear interaction between two-dimensional viscous-inviscid panel method and vortex ring method. The potential flow of a two-dimensional airfoil by the pioneering Hess & Smith method was used with viscous laminar, transition and turbulent boundary layer to solve flow about complex configuration of airfoils including stalling effect. Viterna method was used to extend the aerodynamic characteristics of the specified airfoil to high angles of attacks. A modified vortex ring method was used to find the circulation values along span wise direction of the wing and then interacted with sectional circulation obtained by Kutta-Joukowsky the
... Show MoreThis paper signifies the contradictory point of view in John Clare’s poetry. Clare (1794-1864) is an English romantic poetry in the nineteenth century, who writes more than ten volumes about nature. So, this study highlights the concept of Psychoanalytic theory which is ‘ambivalence’ and how through this theory can interpret any literary text on the basis of utilizing psychoanalytic methods to literary texts in order to reveal the author's inner emotions such as motives, dreams, as well as wishes. Consequently, the concept of ‘ambivalence’ has a lot in common with the human psyche and its struggles. Sometimes the reader finds the author/poet talking about something real or a notion with pleasant sentiments
... Show MoreBackground: Fiber-optic endoscopy is an important
investigation of the large intestine, whether or not the
radiologist (barium enema) has discovered a lesion in
the bowel. Colonoscopy affords a unique opportunity
to direct visualization of entire colonic mucosa. At
the same time, the physician can obtain biopsy specimens, remove polyps, and decompress volvuli.
Most experienced endoscopists and well prepared
patients can reach the cecum in over 90% of patients.
If colonoscopy is properly performed, it has a low
risk of complications, such as perforation and bleeding.
Methods: A total of 70 consecutive patients admitted
to Endoscopy department at Al-Kindy Teaching hospital from September- 2008 to July-2009.