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.
Tillage appearance device is mechanical, electric-electronic design, getting Patent from the Central Organization for Standardization and Quality Control – Industrial Property Department - Ministry of Planning – The Republic of IRAQ under number Patent 3876 in 20 / 4 / 2014, calculates the number of clods per area by Tillage appearance device, This is done through the generation electrical impulses are sent to the controlled accurate calculates number clods required space and shows the result on the screen in order to see the tillage view per area. Three factor used in these experiment, first factor represents forward speed of tractor three levels (3.5, 4.5, and 5.5 km/h), second factor represent soil moisture content at two levels (14
... Show MoreBacterial toxins are considered to be virulence factors due to the fact that they interfere with the normal processes of the host cell in which they are found. The interplay between the infectious processes of bacteria and the immune system is what causes this impact. In this discussion, we are going to focus on bacterial toxins that act in the extracellular environment, especially on those that impair the activity of macrophages and neutrophils. These toxins are of particular interest since they may be found in a wide variety of bacteria. We will be concentrating our efforts, in particular, on the toxins that are generated by Gram-positive and Gram-negative bacteria. These toxins are able to interact with and have an effect on the many dif
... Show MoreThe performa of evaluation process is a process that should be carried out by all industrial management in order to stand on aspects of development or underdevelopment of the various departments and activities in its industrial project for the purpose of identifying obstacles and find out the causes and then avoid them quickly. And intended to rectify the performance evaluation of the activities of industrial project or economic union by measuring the results achieved within a specific operational process and compare it to what is already targeted, and often the time for comparison of one year.
The process of performance evaluation depends upon several criteria and indicators within the
... Show MoreThe aim of this essay is to use a single-index model in developing and adjusting Fama-MacBeth. Penalized smoothing spline regression technique (SIMPLS) foresaw this adjustment. Two generalized cross-validation techniques, Generalized Cross Validation Grid (GGCV) and Generalized Cross Validation Fast (FGCV), anticipated the regular value of smoothing covered under this technique. Due to the two-steps nature of the Fama-MacBeth model, this estimation generated four estimates: SIMPLS(FGCV) - SIMPLS(FGCV), SIMPLS(FGCV) - SIM PLS(GGCV), SIMPLS(GGCV) - SIMPLS(FGCV), SIM PLS(GGCV) - SIM PLS(GGCV). Three-factor Fama-French model—market risk premium, size factor, value factor, and their implication for excess stock returns and portfolio return
... Show MoreConsider a simple graph on vertices and edges together with a total labeling . Then ρ is called total edge irregular labeling if there exists a one-to-one correspondence, say defined by for all where Also, the value is said to be the edge weight of . The total edge irregularity strength of the graph G is indicated by and is the least for which G admits edge irregular h-labeling. In this article, for some common graph families are examined. In addition, an open problem is solved affirmatively.
The Caputo definition of fractional derivatives introduces solution to the difficulties appears in the numerical treatment of differential equations due its consistency in differentiating constant functions. In the same time the memory and hereditary behaviors of the time fractional order derivatives (TFODE) still common in all definitions of fractional derivatives. The use of properties of companion matrices appears in reformulating multilevel schemes as generalized two level schemes is employed with the Gerschgorin disc theorems to prove stability condition. Caputo fractional derivatives with finite difference representations is considered. Moreover the effect of using the inverse operator which tr
Background: Nursing interventions tailored to the smoking triggers in patients with non-communicable chronic diseases are essential. However, these interventions are scant due to the nature of factors associated with smoking cessation and the poor understanding of the effect of nurse-led intervention in Iraq.Purpose: This study aimed to determine the dominant smoking triggers and examine the effects of a tailored nursing intervention on smoking behavior in patients with non-communicable chronic diseases.Methods: Convenience samples of 128 patients with non-communicable chronic diseases, male and female patients, who were 18-70 years old, were recruited in this quasi-experimental, randomized comparative trial in the outpatient clinic
... Show MoreBackground: Recurrent aphthous stomatitis (RAS) is one of the most common oral mucosa diseases characterized by recurrent, shallow, round or oval painful oral ulcers surrounded by inflammatory erythematous halos, the condition is chronic and self-limiting in immunocompetent patients. Aim of the study: to investigate the serum vitamin D levels in Iraqi female patients with RAS and the relationship between vitamin D levels and the severity of RAS. In this cross sectional study 30 female patients with idiopathic RAS, and 30 age and sex matched healthy controls were included, the severity of RAS is assessed by the number of oral aphthous ulcers in each attack and the frequency of attacks. Serum 25(OH) D levels were determined by the Enzy
... Show MoreBackground: Colorectal cancer is the third most common cancer-related mortality worldwide, and its prevalence is increasing among many nations. Aim of the study: Investigate the predictive value of carbohydrate antigen 242 (CA242) in comparison to the CEA biomarker and to estimate the significance of CA242 as prognosis maker in colorectal cancer patients. Methods: a case-control study with a total of 150 individuals, 100 patients (59 males, 41 females) and 50 healthy controls (26 males, 24 females). using an enzyme-linked immunosorbent (ELISA) to determine the serum levels of CA242 and CEA. The study was carried out at the gastroenterology consultation clinic of the oncology teaching hospital between November 2020 and February
... Show MoreMT Suhail, SA Hussein, MN Abdulhussein, WQ Abdaullateef, M khairallah Aid…, Migration Letters, 2024