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.
The study area comprises Injana Formation (Late Miocene), exposed on the hills nearby of Tharthar Lake and about 120 km north of Baghdad city. This study depends on sedimentologic and facies analysis to recognize paleoenvironment and recognize the kinds of vertebrate bone fossils during Late Miocene. Sedimentologic and facies analysis showed many sedimentary facies: facies (Se) of scoured erosional surface, facies of (Sp) cross- bedded sandstones, facies (Fs) of fine sandstone facies, facies of (Fc) claystone, and facies of (C) calcareous clay. Facies analysis referred to the sub environments which are: point bar, over bank and floodplain in addition to fining upward cycles of deposition, which refers to meandering flu
... Show MoreThe research aims to identify the risks faced by projects and work on the administration, such as those risks by using professional Project Management System (Project Management Professional) by identifying those risks and their impact on the objectives of the project, if they occur and to provide appropriate responses to Ha.autam search application on the draft Law Faculty port by the General Mansour Construction Contracting company has been using a method personal interview with the heads of departments and project managers in the Al-Mansour and tools descriptive and quantitative analysis as was used (likelihood and impact of risk analysis, Ai_kaoa scheme Sbb- effect, analysis of probability and impact, risk matrix (probability
... Show MoreAcinetobacter baumannii (A. baumannii ) is considered a critical healthcare problem for patients in intensive care units due to its high ability to be multidrug-resistant to most commercially available antibiotics. The aim of this study is to develop a colorimetric assay to quantitatively detect the target DNA of A. baumannii based on unmodified gold nanoparticles (AuNPs) from different clinical samples (burns, surgical wounds, sputum, blood and urine). A total of thirty-six A. baumannii clinical isolates were collected from five Iraqi hospitals in Erbil and Mosul provinces within the period from September 2020 to January 2021. Bacterial isolation and biochemical identification of isolates
... Show MoreTernary semiconductors AB5C8 (A = Cu/Ag, B = In and C = S, Se or Te) have been investigated. The CuIn5S8 and AgIn5S8 have been synthesize in cubic spinel structure with space group (Fd3m), whereas CuIn5Se8, AgIn5Se8, CuIn5Te8 and AgIn5Te8 have tetragonal structures with space group P-42m. The relaxed crystal geometry, electrical properties such as electronic band structure and optoelectronic properties are predicted by using full potential method in this work. For the determination of relaxed crystal geometry, the gradient approximation (PBE-GGA) is used. All the studied compounds are semiconductors based on their band structures in agreement with the experimental results, and their bulk moduli are in the range 35 to 69 GPa. Wide absorption
... Show MoreThis work discusses the beginning of fractional calculus and how the Sumudu and Elzaki transforms are applied to fractional derivatives. This approach combines a double Sumudu-Elzaki transform strategy to discover analytic solutions to space-time fractional partial differential equations in Mittag-Leffler functions subject to initial and boundary conditions. Where this method gets closer and closer to the correct answer, and the technique's efficacy is demonstrated using numerical examples performed with Matlab R2015a.
This research explores the concept of cruel optimism in the context of challenging patriarchal, cultural, and social traditions in Ayad Akhtar’s The Who and the What. Cruel optimism, a term coined by Lauren Berlant, refers to the paradoxical attachment to positive aspirations that may ultimately obstruct personal fulfillment and well-being. This study examines how individuals who resist patriarchal norms and entrenched cultural traditions often face significant emotional, psychological, and social challenges. Through a multidisciplinary approach, including literary analysis, sociological perspectives, and psychological insights, the research delves into the lived experiences of those who strive for autonomy, equality, and self-realization
... Show MoreThe present study deals with the effect of self -observation on EFL University students` achievement in conversation classes. The process of self-observation helps the teacher to understand one’s own actions and the reactions in the process of teaching. The sample of this study is EFL students in the third stage at the Department of English Language, morning studies, College of Education /Ibn-Rushd .The sample of the study consists of (84) students distributed on experimental group(A) includes (42) students, and (42) students as control group(B). In order to achieve the aim of the study ,and to gain a closer idea about the impact of reflective teaching technique(self-observation) on the students achievement in conversation classes, a chec
... Show MoreBackground: In Iraqi communities, the workers considered the largest population groups, so increasing their dental education by increasing the care for their dental health knowledge and behavior is very important, the present study was aimed to evaluate the gingival health and oral hygiene in relation to knowledge and behavior among a group of a workers selected randomly from Al Fedaa company in Baghdad city. Materials and methods: A sample of 110 workers (65 men and 45 women) included in this study, a questionnaire used to evaluate their oral health knowledge and behavior. The gingival health condition of the workers was examined by using Loe and Silness index (1963), Silness and Loe index (1964) was used to asses plaque quantity, and Ramf
... Show MoreIn this review, numerous analytical methods to distinguish pigments in tattoo, paint, and ink items are discussed. The selection of a method was dependent upon the purpose, e.g., quantification or identification of pigments. The introductory part of this review focuses on describing the importance of setting up a pigment-associated safety profile. The formation of different degradation chemical substances as well as impurity trends can be indicated through the chemical investigation of pigments in tattoo products. It is noteworthy that pigment recognition in tattoo inks can work as a preliminary method to identify the pigments in a patient's tattoo before being removed by laser therapy. Contrary to the stud