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.
Background:The effects of contraception on Trichomonas vaginalis have important implications for women who suffer from infections associated with disruptions in the vaginal ecology, such as bacterial vaginitis and urinary tract infections.
Objective: To find the association of the common types of contraceptions with the Trichomonasvaginalis infection in women admitted to the Al-BatoolTeaching Hospital for Maternity and Children in Baqubah city.
Type of study: Cross-sectional study
Methods: This study consist of 75 women with contraception use and71 apparently healthy non contraception user women admitted to outpatient in Al
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The grey system model GM(1,1) is the model of the prediction of the time series and the basis of the grey theory. This research presents the methods for estimating parameters of the grey model GM(1,1) is the accumulative method (ACC), the exponential method (EXP), modified exponential method (Mod EXP) and the Particle Swarm Optimization method (PSO). These methods were compared based on the Mean square error (MSE) and the Mean Absolute percentage error (MAPE) as a basis comparator and the simulation method was adopted for the best of the four methods, The best method was obtained and then applied to real data. This data represents the consumption rate of two types of oils a he
... Show Morethe digital public relations aim at make the workers getting the necessary information about the governmental institutions where they work and the enveronment surrounding them. it also tries to let the workers get the special knowlege of tthe publich relations and their jobs like the works of planning , arranging the active communication and executive skills needed in their writing , editing , special art skills for designing , production and technological skills to deal with the computer.
the problem of the research includes some questions as :
1- what are the uses achieved by degetal public relations workers at Iraqi universities (Baghdad, Mustansiriya, and Iraqi)
2- what are the tools used to apply digital public relations
Despite the availability of information technology banking features and benefits of the banking sector, they involve many risks and challenges and put in the face of the administrative authorities and regulatory institutions in the banking system, organizational matters and control sensitive and bear direct responsibility for conducting independent assessments of their regulatory and information and determine the degree of its durability and its ability to confront problems imposed by the technical challenges and technological .
And the success of the administrative authorities and regulatory institutions in achieving its objectives in the management of risks and threats oversight resulting from the act
in the present article, we present the peristaltic motion of “Hyperbolic Tangent nanofluid” by a porous area in a two dimensional non-regular a symmetric channel with an inclination under the impact of inclination angle under the impact of inclined magnetic force, the convection conditions of “heat and mass transfer” will be showed. The matter of the paper will be further simplified with the assumptions of long wave length and less “Reynolds number”. we are solved the coupled non-linear equations by using technical analysis of “Regular perturbation method” of series solutions. We are worked out the basic equations of continuity, motion, temperature, and volume fraction
The heavy metal cadmium is extremely harmful to both humans and animals. Zinc supplementation protects the biological system and reduces cadmium-induced toxicity. This study aimed to determine whether zinc chloride (ZnCl2) could protect male mice with the damaged liver induced by cadmium chloride (CdCl2). The protective role of zinc chloride and expression of the metallothionein (MT), Ki-67, and Bcl-2 apoptotic proteins in hepatocytes were studied after subchronic exposure of mice to cadmium chloride for 21 days. Thirty male mice were randomly categorized into 6 groups (5 mice/group) as follows: a control group that did not receive any treatment, a group given ZnCl2 at 10 mg/kg alone, and two groups received ZnCl2 (10 mg/kg) i
... Show MoreThe topic of strategic intelligence is considered as important topics that acquires the attention of organizations, Because of its role in supplying the decision-making centers by strategic ideas according to the opportunities and threats facing the organization, in an effort to improve the performance of their organizations to reach the high performance organization.
A lot of organizations lack to strategy guides the strategic intelligence towards achieving high performance organization.
This research aims to determine the level of strategic intelligence that characterized the leaders of diseases and kidney transplant center in Medicine city. What is the application level of the
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Arzı Kanber/Kamber hikayesi Anadolu, Rumeli, Azerbaycan, Türkmenistan ve Irak gibi Türk dünyasının birçok yerinde birden fazla varyantı bulunan, çok sevilen ve yaygın olarak anlatılan aşk ve dramatik maceralı bir halk hikayesidir. Türk halk hikayelerinin en popüler olanlarından biri sayılan Arzı Kanber/Kamber hikayesi, Anadolu'nun birçok yöresinde bilinmesine rağmen Irak Türkmenleri arasında daha çok sevildiği ve yaygın olarak anlatıldığı tespit edilen birden fazla varyantından da görülebilir. Irak Türkmenleri arasında günümüze kadar hikayenin iki varyantı tespit edilmi
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