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.
Media studies have focused mostly on the issue of the mental image because the image that is formed in the mind has become not only a photo of a human being and having kept for himself. This image has an outside influence which may sometimes up to the formation of the fate of others and it sometimes includes individuals and groups together.
This study comes in the context of identifying the image of Iraqi political parties among Iraqi university students and the nature of the view that students have in their minds about these parties.
Chapter one includes the problem of the research, the importance of the study, the goals and method used. Chapter two is divided into two sections: section one deals with the concept of the mental i
This work has been accomplished through a dense field work on the Sawa Lake. The aim of this work is to highlight on characteristics that are consistent with outstanding universal values to be a new Iraqi site belongs to the World Natural Heritage. This study sorted many unique characteristics might ensure that Sawa Lake as a world natural heritage sites. This study shows that the lake had met four natural criteria of the outstanding universal values: (1) the seventh criterion which states to contain superlative natural phenomena or areas of exceptional natural beauty and aesthetic importance. (2) The eighth criterion which stated to be outstanding example representing major stages of earth's history, including the rec
... Show MoreThis research aimed to diagnose the perception based on Telecommunications of Iraq to the importance of activating knowledge management marketing in possession, as well as Indication of impediments to activate the management of marketing knowledge in the researched companies, also aimed to show the extent of the existence of significant differences in perception based on Telecommunications Iraqi importance of activating the management marketing knowledge in possession. To achieve the objectives of this research, the questionnaire was developed and distributed to a sample of telecommunications companies in the city of Sulaimaniya, was selected on the criterion according to the company's life in terms of seniority in the telecommunication
... Show MoreDuring the course of fixed orthodontic therapy, patients should be instructed to eat specific food stuffs and beverages in order to maintain good health for the dentition and supporting structures and prevent frequent attachment debonding that prolong the treatment duration. After searching and collecting articles from 1930 till July 2021, the current review was prepared to emphasize various types of foods that should be taken during the course of fixed orthodontic therapy and to explain the effect of various food stuffs and beverages on the growth and development of craniofacial structures, tooth surfaces, root resorption, tooth movement, retention and stability after orthodontic treatment and the effect on the components of fixed ortho
... Show MoreIn this review paper, several research studies were surveyed to assist future researchers to identify available techniques in the field of infectious disease modeling across complex networks. Infectious disease modelling is becoming increasingly important because of the microbes and viruses that threaten people’s lives and societies in all respects. It has long been a focus of research in many domains, including mathematical biology, physics, computer science, engineering, economics, and the social sciences, to properly represent and analyze spreading processes. This survey first presents a brief overview of previous literature and some graphs and equations to clarify the modeling in complex networks, the detection of soc
... Show MoreObjectives: Although the Frankfort Horizontal (FH) and sella-nasion were routinely used as craniofacial reference planes, the inter-individual orientations were changeable when related to true horizontal (HOR). Natural head position (NHP) is a reproducible, standardized position, with the head in an upright posture and eyes focused on a point in the distance at eye level so that the visual axis is horizontal. The natural head position has importance in anthropological as well as in orthodontic fields, as this position has a relatively fixed relationship to the true horizontal and vertical planes. However, NHP is clinically not simple and it takes long time to be recorded, in addition to a deficiency in the tools utilized in the NHP and l
... Show MoreIn this review paper, several research studies were surveyed to assist future researchers to identify available techniques in the field of infectious disease modeling across complex networks. Infectious disease modelling is becoming increasingly important because of the microbes and viruses that threaten people’s lives and societies in all respects. It has long been a focus of research in many domains, including mathematical biology, physics, computer science, engineering, economics, and the social sciences, to properly represent and analyze spreading processes. This survey first presents a brief overview of previous literature and some graphs and equations to clarify the modeling in complex networks, the detection of soc
... Show MoreOptimization of gas lift plays a substantial role in production and maximizing the net present value of the investment of oil field projects. However, the application of the optimization techniques in gas lift project is so complex because many decision variables, objective functions and constraints are involved in the gas lift optimization problem. In addition, many computational ways; traditional and modern, have been employed to optimize gas lift processes. This research aims to present the developing of the optimization techniques applied in the gas lift. Accordingly, the research classifies the applied optimization techniques, and it presents the limitations and the range of applications of each one to get an acceptable level of accura
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