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.
The article reflects the results of the analysis of the use of metaphors as one of the main means used by Lyudmila Ulitskaya when writing the novel “Sincerely Yours Shurik” to form the image of the main hero in the novel. The main purpose of the article is to consider metaphors, which helped the author to form the image of the main character Shurik in the text space through the stages of his life path, closely related to the people around him, who is always happy to be useful (hence the title "Sincerely Yours"), among which the female images of his relatives, girlfriends and others stand out as a special layer in the narrative. And in the course of the study, the following tasks were solved: the metaphors that make up the image of the
... Show MoreObjective(s): to assess the effectiveness of educational program on nurses' knowledge concerning the side
effects of chemotherapy among children with leukemia.
Methodology: A descriptive analytic (quasi – experimental) design study was carried out at Baghdad City from
2
nd of October to 27th of June 2015. Non-probability sample of (35) male and female nurses was selected from
the Oncology Wards in Children Welfare, Child's Central and Baghdad Teaching Hospital. The study
instruments consisted of two major parts to meet the purposes of study. The first part is related to nurses'
demographic characteristics and the second part (four domains) is related to nurses' knowledge concerning the
side effects of chemothera
Indium oxide In2O3 thin films fabricated using thermal evaporation of indium metal in vacuum on a glass substrate at 25oC using array mask, after deposition the indium films have been subjected to thermal oxidation at temperature 400 °C for 1h. The results of prepared Indium oxide reveal the oxidation method as a strong effect on the morphology and optical properties of the samples as fabricated. The band gap (Eg) of In2O3 films at 400 °C is 2.7 eV. Then, SEM and XRD measurements are also used to investigate the morphology and structure of the indium oxide In2O3 thin films. The antimicrobial activity of indium oxide In2O3 thin films was assessed against gram-negative bacterium using inhibition zone of bacteria which improved higher ina
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Collapse of the vapor bubble condensing in an immiscible is investigated for n-pentane and n-hexane vapors condensing in cold water and n-pentane in two different compositions of glycerin- water mixture. The rise velocity and the drag coefficient of the two-phase bubble are measured.
The Islamic Banks including the Iraqi ones are often resorted to support their governance frameworks in order to improve its competitiveness in their communities. Where, those banks are looking for activities that enhance their governance; one of these activities is Shariah Audit that provided the auditing capabilities to face of developmental challenges and increase competitiveness. Therefore, the content of this paper, discusses know-how to use the Shariah Audit and its references in support of the Shariah Governance in the Iraqi Isla
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Urban wetlands are one of the complex systems that provide many economic, social and environmental services to the city. In this research, the most important services provided by urban wetlands from the point of view of the urban planner were reviewed, and the types of these lands and their divisions according to the type of services provided by each type were presented. Environmental is represented in its ability to reduce the dangers of floods, mitigate the climate and reduce its negative impacts, purify water and deplete a lot of suspended impurities and pollutants, and social services such as recreational areas and beautiful landscapes that inspire joy and reassurance in the soul, as well as cultural areas and sports activities for m
... Show MoreThe current study aims to investigate the effect of the interaction between the use of the improve strategy in teaching mathematics and the level of academic achievement on the acquisition of algebraic concepts and habits of mind among tenth-grade students in Oman. The study adopted the experimental method, based on a quasi-experimental design with two groups: experimental and control groups and pre-post-measurement. The study sample consisted of (28) 10th-grade students as an experimental group and 26 of 10th-grade students as a control group in Al-Tufail bin Amr School in South Al Batinah. The differences in the pretest and posttest gains were analyzed using mean, standard deviation, ANCOVA, t-test, effect size (eta-square), and two-wa
... Show MoreDevelopment of improved methods for the synthesis of metal oxide nanoparticles are of high priority for the advancement of material science and technology. Herein, the biosynthesis of ZnO using hydrahelix of beta vulgaris and the seed of abrus precatorius as an aqueaus extracts adduced respectivily as stablizer and reductant reagent. The support are characterized by spectroscopic methods ( Ft-IR, Uv-vis ).The FTIR confirmed the presence of ZnO band. The Uv-visible showed absorption peak at corresponds to the ZnO nanostructures. X-ray diffraction, scaning electron microscopy (SEM), dispersive X-ray spectroscopy (EDX) techniques are taken to investigation the size, structure and composition of synthesised ZnO nanocrystals. The XRD pattern mat
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Theoretical and experimental methodologies were assessed to test curved beam made of layered composite material. The maximum stress and maximum deflection were computed for each layer and the effect of radius of curvature and curve shape on them. Because of the increase of the use of composite materials in aircraft structures and the renewed interest in these types of problems, the presented theoretical assessment was made using three different approaches: curved beam theory and an approximate 2D strength of material equations and finite element method (FEM) analysis by ANSYS 14.5 program for twelve cases of multi-layered cylindrical shell panel differs in fibe
... Show MoreAnastatica hierochuntica is believed to be very useful in Arab countries for treating various health disorders. The aqueous extract of Anastatica hierochuntica was investigated for its effects on hormones in mice females. the aqueous extract of plant at a dose level of 100mg/1mL showed significant increase (p<0.05) on levels of hormones LH, FSH, PRL level and PRO level. Clomid treated group showd significant increase in LH, FSH, and PRL while there was non-significant increase in PRO. From the above results, it is concluded for the first time that aqueous Anastatica hierchuntica extract offers significant effect of LH, FSH, PRL, and PRO in this mice females scompared with control.