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.
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In today’s competitive environment, organizational efficiency and sustained growth are crucial for survival. The performance of an organization is intricately connected to strategic planning, prompting firms to gather and leverage competitive information for a competitive advantage. Senior managers, recognizing this, initiate actions accordingly. This study aims to investigate the relationship between foresight, vision, strategic partnerships, motivation, system thinking, and organizational performance. Data, gathered through a self-administered questionnaire from various textile units, were analysed using structural equation modelling (SEM). The findings indicate that sub-constructs of strategic intelligence positively impact organizatio
... Show MoreBackground: The evaluation of the chronological age is a practical method in crime investigation field that assists in identifying individuals to treat them as underage or adult. This study aimed to assess the stages of third molars mineralization in relation to chronological age of Iraqi individuals, determine the gender differences and arches (maxillary/mandibular) differences.
Materials and Methods: A total of 300 orthopantomograms of orthodontic patients were collected according to specific criteria and evaluated visually. The developmental stages of maxillary and mandibular third molars were determined according to Demirjian method. T
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Flow-production systems whose pieces are connected in a row may not have maintenance scheduling procedures fixed because problems occur at different times (electricity plants, cement plants, water desalination plants). Contemporary software and artificial intelligence (AI) technologies are used to fulfill the research objectives by developing a predictive maintenance program. The data of the fifth thermal unit of the power station for the electricity of Al Dora/Baghdad are used in this study. Three stages of research were conducted. First, missing data without temporal sequences were processed. The data were filled using time series hour after hour and the times were filled as system working hours, making the volume of the data relativel
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The mediation system is based on settling the dispute amicably through the intervention of a third party by bringing views closer away from the judiciary, which is an amicable way to settle disputes, which disputants resort to voluntarily, but some Western legislation has begun to impose resorting to mediation to settle disputes compulsorily, to take advantage of its advantages, get rid of the disadvantages of resorting to the judiciary in some disputes, and relieve pressure on the courts.
The comparative study tries to find the common points in two different authors’ works and in this kind of studying so many other common but the hidden points may be revealed. Postwar literature is somehow one of the best literary genres for finding the common factors and features that the poets have tried to present in their works elements such as desire to be winner, cruelty, inhumanity, and absurdity of the war. The Iranian poet late Qaisar Aminpour(1961-2007) and Yusef Komunyakaa ( 1947) from Bogalusa, Louisiana, are among the great American and Iranian poets whose works so many times have been interpreted and analyzed. The finding the outstanding and the most important points and themes in the postwar poems of these
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The present work deals with five species of parasitic Hymenoptera belonging to Pteromalidae, Eupelmidae and Eurytornidae which have been reared from brachid beetles. A new species, Eurytoma irakensis is described and the species, Bruchocida orientalis Crawford is recorded for the first time from Iraq.
Mixed convection heat transfer in a vertical concentric annulus packed with a metallic porous media and heated at a constant heat flux is experimentally investigated with water as the working fluid. A series of experiments have been carried out with a Rayleigh number range from Ra=122418.92 to 372579.31 and Reynolds number that based on the particles diameter of Red=14.62, 19.48 and 24.36. Under steady state condition, the measured data were collected and analyzed. Results show that the wall surface temperatures are affected by the imposed heat flux variation and Reynolds number variation. The variation of the local heat transfer coefficient and the mean Nusselt number are presented and analyzed. An empirical
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