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.
Abstract
In order to make an improvement associated with rotating biological contactor (RBC), a new design of biofilm reactor called as Rotating perforated disc biological contactor (RPBC) was developed in which the rotating discs are perforated. The transfer of oxygen from air to wastewater was investigated. Mass-transfer coefficient (KLa) in the liquid phase was determined by measuring the rate transfer of oxygen. A laboratory scale of (RPBC) consisted of a semicircular trough was used with a working capacity of 40 liters capacity of liquid. Synthetic wastewater was used as a liquid phase, while air was used as a gas phase.
The effects of m
... Show MoreBackground: Surface treatment of machined dental zirconia for enhancement of the adhesion to resin cement, using Er,Cr:YSGG Laser. Materials and Methods: Total number of 42 zirconia disc specimens (9 mm diameter, and 2 mm height) was sintered according to the manufacturer instruction. They are divided into six groups, each group of seven samples. Laser groups (Experiment parameters) were depend on laser total irradiation time, pulse duration, and power. Group (A): 20 sec., 60 µs pulse duration. Group (B): 30 sec., 60 µs pulse duration. Group (C): 40 sec., 60 µs pulse duration. Group (D): 20 sec., 700 µs pulse duration. Group (E): 30 sec., 700 µs pulse duration, with different powers used (1, 1
... Show MoreThe removal of boron from aqueous solution was carried out by electrocoagulation (EC) using magnesium electrodes as anode and stainless steel electrodes as cathode. Several operating parameters on the removal efficiency of boron were investigated, such as initial pH, current density, initial boron ion concentration, NaCl concentration, spacing between electrodes, electrode material, and presence of carbonate concentration. The optimum removal efficiency of 91. 5 % was achieved at a current density of 3 mA/cm² and pH = 7 using (Mg/St. St. ) electrodes, within 45 min of operating time. The concentration of NaCl was o. 1 g/l with a 0.5cm spacing between the electrodes. First and second order rate equation were applied to study adsorp
... Show MoreThe performance of a batch undivided electrochemical reactor with a rotating cylinder electrode of woven-wire (60 mesh size), stainless steel 316, is examined for the removal of copper from synthetic solution of o.5 M sodium chloride containing 125 ppm at pH ≈ 3.5. The effect of total applied current, rotation speed on the figures of merit of the reactor is analyzed. For an applied current of 300 mA at 100 rpm, the copper concentration decreased from 125 to mg l-1 after 60 min of electrolysis with a specific energy consumption of 1.75 kWh kg-1 and a normalized space velocity of 1.62 h-1. The change in concentration was higher when the total applied currents were increased because of the turbulence
... Show MoreGeneralized multivariate transmuted Bessel distribution belongs to the family of probability distributions with a symmetric heavy tail. It is considered a mixed continuous probability distribution. It is the result of mixing the multivariate Gaussian mixture distribution with the generalized inverse normal distribution. On this basis, the paper will study a multiple compact regression model when the random error follows a generalized multivariate transmuted Bessel distribution. Assuming that the shape parameters are known, the parameters of the multiple compact regression model will be estimated using the maximum likelihood method and Bayesian approach depending on non-informative prior information. In addition, the Bayes factor was used
... Show MoreThis work intends to illustrate the methods of using the authentic literary text in the process of spreading Italian, especially in Baghdad where there is a strong propensity to learn the Italian language. The concept of the language that arises from literature is an idea closely linked to the mentality of the Arab learner towards Italian culture: an idea also created by the first Arabisations of literary texts in the early years of the previous century. The research was carried out in Baghdad by two researchers, an Italianist from Baghdad and an Italian mother language linguist, with the aim of bringing together the two sectors in favor of the diffusion of the Italian language. The study also aims to clarify the models from Italian l
... Show MoreBackground: Background : Patients with non-rheumatic atrial fibrillation have high risk of thromboembolism especially ischemic stroke usually arising from left atrial appendage .Transoesophageal echocardiography provides useful information for risk stratification in these patients as it detects thrombus in the left atrial or left atrial appendage. Objective : This study was conducted at Al-Kadhimiya Teaching Hospital to assess the prevalence of left atrial chamber thrombi in patients with chronic non-rheumatic atrial fibrillation using transoesophageal echocardiography and its clinical significance as well as to verify the superiority of transoesophageal over transthoracic echocardiography in the detection of these abnormalities. Type of
... Show MoreBackground: Bowel preparation prior to
colonic surgery usually includes antibiotic
therapy together with mechanical bowel
preparation which may cause discomfort to the
patients, prolonged hospitalization and water
& electrolyte imbalance.
Objective: to assess whether elective colon
and rectal surgery may be safely performed
without preoperative mechanical bowel
preparation.
Method: the study includes all patients who
had elective large bowel resection at Medical
City – Baghdad Teaching Hospital between
Feb, 2007 to Jan, 2010. Emergency operations
were not included. The patients were randomly
assigned to the 2 study groups (with or without
mechanical bowel preparation.
Results: A to

Necessary and sufficient conditions for the operator equation I AXAX n*, to have a real positive definite solution X are given. Based on these conditions, some properties of the operator A as well as relation between the solutions X andAare given.