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.
Cohesion is well known as the study of the relationships, whether grammatical and/or lexical, between the different elements of a particular text by the use of what are commonly called 'cohesive devices'. These devices bring connectivity and bind a text together. Besides, the nature and the amount of such cohesive devices usually affect the understanding of that text in the sense of making it easier to comprehend. The present study is intendedto examine the use of grammatical cohesive devicesin relation to narrative techniques. The story of Joseph from the Holy Quran has been selected to be examined by using Halliday and Hasan's Model of Cohesion (1976, 1989). The aim of the study is to comparatively examine to what extent the type
... Show MoreIn this paper, an analytical solution describing the deflection of a cracked beam repaired with piezoelectric patch is introduced. The solution is derived using perturbation method. A novel analytical model to calculate the proper dimensions of piezoelectric patches used to repair cracked beams is also introduced. This model shows that the thickness of the piezoelectric patch depends mainly on the thickness of the cracked beam, the electro-mechanical properties of the patch material, the applied load and the crack location. Furthermore, the model shows that the length of the piezoelectric patches depends on the thickness of the patch as well as it depends on the length of the cracked beam and the crack depth. The additio
... Show MoreThe majority of Iraqi translator-student have problems at two main levels: the conceptual level and the productive level. From different perspectives, such problems are either related to ‘language’ or to ‘cognition’. This binary view is an indication to the implicit and interchangeable relationship between language and cognition. The relationship between cognition language and translator starts with the first language and its effect on the Iraqi translators. Identifying the effect is the aim of the present study. It is hypothesized that Iraqi students are negatively influenced by the problems and weaknesses of first language schema. This reflects the major claim and later concludes that first language instruction in the Iraq
... Show MoreThe population has been trying to use clean energy instead of combustion. The choice was to use liquefied petroleum gas (LPG) for domestic use, especially for cooking due to its advantages as a light gas, a lower cost, and clean energy. Residential complexes are supplied with liquefied petroleum gas for each housing unit, transported by pipes from LPG tanks to the equipment. This research aims to simulate the design and performance design of the LPG system in the building that is applied to a residential complex in Baghdad taken as a study case with eight buildings. The building has 11 floors, and each floor has four apartments. The design in this study has been done in two parts, part one is the design of an LPG system for one building, an
... Show MoreIn spite of the disappearing of a clear uniform textbook for teaching ESP at different departments and different colleges in both scientific and humanistic studies, the practitioners at those departments and colleges have to teach translation as one of the important requirements to pass the English language exam. The lack of defined translation activities is a noticeable problem therefore; the problem of teaching translation is diagnosed in that the students lack the ability to comprehend the text in English language and other translation knowledge and skills.
The study aims to suggest a translation strategy and then find out the effect of the translation strategy on ESP learners’ achievement in translation. A sample of 50 stud
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