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.
Acute lymphoblastic leukemia (ALL) is a cancer of the blood and bone marrow (spongy tissue in the center of bone). In ALL, too many bone marrow stem cells develop into a type of white blood cell called lymphocytes. These abnormal lymphocytes are not able to fight infection very well. The aim of this study was to investigate possible links between E3 SUMO-Protein Ligase NSE2 [NSMCE2] and increase DNA damage in the childhood patients with Acute lymphoblastic leukemia (ALL). Laboratory investigations including hemoglobin(Hb) ,white blood cell (WBC) , serum total protein , albumin ,globulin , in addition to serum total antioxidant activity (TAA) , Advanced oxidation protein products(AOPP) and E3 SUMO-Protein Ligase NSE2[NSMCE2]. Blood samples
... Show MoreIn this paper, the system of the power plant has been investigated as a special type of industrial systems, which has a significant role in improving societies since the electrical energy has entered all kinds of industries, and it is considered as the artery of modern life.
The aim of this research is to construct a programming system, which could be used to identify the most important failure modes that are occur in a steam type of power plants. Also the effects and reasons of each failure mode could be analyzed through the usage of this programming system reaching to the basic events (main reasons) that causing each failure mode. The construction of this system for FMEA is dependi
... Show MoreSince the invention of the automobile, no aspect of American life, including crime and its control, has remained untouched by this far-reaching innovation in transportation. Vehicular "hot pursuit"-when suspects in motor vehicles use excessive speed in attempting to elude the police. Unfortunately, accounts of wild chases across crowded inner city streets, through tree-lined suburban boulevards, and over remote country roads are very real and not merely fictional material created for entertaining television and motion picture audiences. The specter of "hot pursuit," complete with screaming sirens and red or blue flashing lights, has become a recurring fact of modem life.1 So, too, are the mishaps involving police vehicles or the vehicles pu
... Show MoreOf the new concepts introduced by the decree of the amendment of the French Civil Code No. 131-2016 issued on 10 February 2016, which raised a debate in jurisprudence both at the level of French jurisprudence or the Arab, the concept of (the content of the contract), which seems to have emerged from the appearance of new legal articles ( 1162-1171) is the cornerstone of the contract and the contract in the contract, the two pillars which, over the course of 200 years and a half, have been one of the main pillars of the codification of Napoleon. Is that the decree of amendment has already abandoned these two pillars, or most of what he did is a change in terminology while preserving the content of these two pillars implicitly, this is what w
... Show MoreThe exchange rate is of great importance at the global and local levels alike, as this importance increases with the increasing rates of development of economic relations between countries of the world due to openness and integration into the global economy, expressed by the expansion of the volume of trade and financial relations between countries. The Central Bank of Iraq has set the need to stabilize this price as a goal to reduce inflation rates and reduce them to the internationally accepted rates by using the foreign currency sale window to achieve a balance between the forces of supply and demand for foreign currency and to preserve the value of the Iraqi dinar. The research concluded that the central bank was It has a maj
... Show MoreUrban expansion and its environmental and safety effects are one of the critical information needed for future development planning, safety considerations and environmental management. This work used two methods to monitor urban expansion and it's environmental and safety effects, the first is based on Google Maps for the years 2002 and 2010, and the second was the usage of spatial videos for the year 2013. Although the usage of satellite images is critical to know and investigate the general situation and the total effects of the expansion on a large piece of area, but the Spatial videos do a very detailed fine scale investigation, site conditions regarding both environmental and safety cannot be easily distinguished fr
... Show MoreIraqi agriculture faces a major water problem, affecting cultivated areas, agricultural production, farmers’ incomes and food security. However, the results achieved in rationalizing the use of irrigation water are still limited and do not match what they should be in order to meet this serious challenge. The study aimed to provide a vision for the development of the effectiveness of the dissemination of innovations to rationalize the use of irrigation water in Iraqi agriculture. In light of the framework of the dissemination of agricultural innovations, factors related to their effectiveness, and the summary of the Iraqi experience in the field of dissemination of modern irrigation
This study aims to measure and analyze the direct and indirect effects of the financial variables, namely (public spending, public revenues, internal debt, and external debt), on the non-oil productive sectors with and without bank credit as an intermediate variable, using quarterly data for the period (2004Q1–2021Q4), converted using Eviews 12. To measure the objective of the study, the path analysis method was used using IBM SPSS-AMOS. The study concluded that the direct and indirect effects of financial variables have a weak role in directing bank credit towards the productive sectors in Iraq, which amounted to (0.18), as a result of market risks or unstable expectations in the economy. In addition to the weak credit ratings of borr
... Show MoreInsurance is one of effective high-impact activities in the economic and social aspects of development and that the insurance companies after the creation of stability, balance and support other sectors. The insurance of financial institutions with economic and social importance has an impact on the development and help shoulder the burden of risk and distribution. And measuring Indicators of service and cost her help in evaluating the performance and activity of insurance, and the study of sectors needed by society, institutions and individuals and development of the company. Covering all aspects of life and activity. In this study will focus on the insurance sector in the field of car accidents and so plentiful and their problems and d
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