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.
Kurdish language multifunctional morphemes indicate the different functional morphological, syntactical, and semantic tasks of the morphemes. The present study discusses the multifunctional task of the Morpheme Le in Kurdish Language. The Morpheme Le has marginally been included in other studies, yet up to the present times, there has not been a research inclusively dedicated to thoroughly discuss and clarify its multifunctional aspects. The present study is divided into two chapters: Chapter one discusses the theoretical aspect of chapter two that is entirely concerned with the practical aspect of the morpheme Le. The first part of chapter one sheds light on the morphological aspect of the morpheme while part two discusses
... Show MoreIraq's oil industry has been passed in different periods , began with domination of Western companies to invest in Iraqi oil at twenties of the last century , through the process of nationalization of the shares of those companies , beginning of the seventies , and ending with the new policies adopted by the government recently, which was contracting with international companies to develop the oil industry , because of what the outcome of the oil industry from a decline in artistic and physical ability as a result to the conditions of war and embargo imposed on Iraq before 2003.
The Iraqi government has introduced licensing of a contract to
... Show MoreChronic myeloid leukemia (CML) is a myeloproliferative disorder characterized by the presence Philadelphia chromosome (Ph) which was created by a reciprocal translocation between chromosomes 9 and 22 (t [9;22] [q34;q11]. The approval of the 2nd generation TKI ( Nilotinib) takes the treatment of CML patients into new erea with more efficiency and mild to moderate adverse effects. This study was aimed at evaluation of molecular cytogenetic response by (FISH) for Nilotinib in Iraqi patients with assessment for electrolytes disturbances of Nilotinb by measuring a panel of electrolyte (Na+, K+, Ca++, PO4--- and Mg++) , where thirty Iraqi patients with CML who have resistance or no response to Imatinib treatment, attending to Baghdad Teaching Ho
... Show MoreThe theory of probabilistic programming may be conceived in several different ways. As a method of programming it analyses the implications of probabilistic variations in the parameter space of linear or nonlinear programming model. The generating mechanism of such probabilistic variations in the economic models may be due to incomplete information about changes in demand, production and technology, specification errors about the econometric relations presumed for different economic agents, uncertainty of various sorts and the consequences of imperfect aggregation or disaggregating of economic variables. In this Research we discuss the probabilistic programming problem when the coefficient bi is random variable
... Show MoreScientists have delved too much into reality and metaphor, and perhaps a topic of Arabic rhetoric has not received the attention and care of scholars as much as the topic of truth and metaphor. The metaphor opens wide horizons of expression in front of the writer so that he has several means by which he can express the one experience, so his imagination takes off depicting the intelligible as tangible, the seen as audible, and the audible as seen. That image presented by the creative writer.
The first thing to note is that the emergence of metaphor as a rhetorical term was at the hands of the Mu'tazila. Muslims differed about the issue of metaphor in the Holy Qur’an, and the beginning of the dispute was about the verses in which the
Background: Endometriosis is defined as the presence or growth of ectopic endometrial tissue outside their usual site ( the uterus). It is a common condition in women. It may occur in the ovaries, fallopian tubes, vagina and rarely, endometriosis may occur in the abdomen and lungs. Endometriosis is common among women of reproductive age. It is either primary or secondary. The triad of diagnosis is a pain with menstruation, cesarean scar and a mass in the scar.
... Show MoreBackground: Appreciation of the crucial role of risk factors in the development of coronary artery disease (CAD) is one of the most significant advances in the understanding of this important disease. Extensive epidemiological research has established cigarette smoking, diabetes, hyperlipidemia, and hypertension as independent risk factors for CADObjective: To determine the prevalence of the 4 conventional risk factors(cigarette smoking, diabetes, hyperlipidemia, and hypertension) among patients with CAD and to determine the correlation of Thrombolysis in Myocardial Infarction (TIMI) risk score with the extent of coronary artery disease (CAD) in patients with unstable angina /non ST elevation myocardial infarction (UA/NSTEMI).Methods: We
... Show MoreThis research seeks to study the role of military bases in activating defense diplomacy, with a focus on studying the case of France in the African continent, which relied on its military bases as a tool to implement its foreign policy. The research explains the concept of defense diplomacy and its relationship to military bases as an effective tool to strengthening bilateral relations between the state's parties. The research focuses on studying the effectiveness of military bases as a tool for activating French defense diplomacy, and studying the goals that French foreign policy seeks to achieve through its intervention or presence in the African continent. In addition to the geopolitical reasons that prompted France to move to
... Show MoreIn this study, (50–110 nm) magnetic iron oxide (α-Fe2O3) nanoparticles were synthesized by pulsed laser ablation of iron target in dimethylformamide (DMF) and sodium dodecyl sulfate (SDS) solutions. The structural properties of the synthesized nanoparticles were investigated by using Fourier Transform Infrared (FT-IR) spectroscopy, UV–VIS absorption, scanning electron microscopy (SEM), atomic force microscopy (AFM), and X-ray diffraction (XRD). The effect of laser fluence on the characteristics of these nanoparticles was studied. Antibacterial activities of iron oxide nanoparticles were tested against Gram-positive; Staphylococcus aureus and Gram-negative; Escherichia coli, Pseudomonas aeruginosa and Serratia marcescens. The results sh
... Show MoreGlobalization as phenomena has affected all aspects of life and reflected its impacts to the Arab world politically, economically, and culturally and became a vital field that related directly to our life. This field of searching needs as many studies and Academics as for employing the means that needed to face a national challenge which targeting the Arabic man Character in its ethics and values. This very important thing needs a very important reaction to face that challenge to protect the cultural ARABIC & ISLAMIC characteristics and to take care of education in all its levels and forms as it is an invincible fort. For that, this field has become as the priority of the studying and researches if the
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