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.
Dam operation and management have become more complex recently because of the need for considering hydraulic structure sustainability and environmental protect on. An Earthfill dam that includes a powerhouse system is considered as a significant multipurpose hydraulic structure. Understanding the effects of running hydropower plant turbines on the dam body is one of the major safety concerns for earthfill dams. In this research, dynamic analysis of earthfill dam, integrated with a hydropower plant system containing six vertical Kaplan turbines (i.e., Haditha dam), is investigated. In the first stage of the study, ANSYS-CFX was used to represent one vertical Kaplan turbine unit by designing a three-dimensional (3-D) finite element (F
... Show MoreRudimentary non-communicating functional uterine horn with unicornuate uterus, originating from anomalous embryological development of one Mullerian duct, is prone to different complications either at the gynecological or obstetrical level such as chronic pelvic pain, hematometra, subfertility and decreased quality of life. This unique case report presents a 14-year-old female with a history of severe chronic pelvic pain. She was diagnosed with Familial Mediterranean Fever (FMF) and had an appendectomy for suspected appendicitis within the symptoms’ interval. Ultrasound showed a right 5*6 cm right complex cystic mass assuming ovarian in place. She underwent a suspected endometrioma cystectomy operation and was diagnosed with left unico
... Show MoreSeeking pharmacist advice about minor ailments is a common practice among Iraqi patients because such advice is free and quick. Unfortunately, the assessment and management of minor ailments by Iraqi pharmacists were inappropriate. Therefore, this study aimed to develop a model for a mobile application that can assist community pharmacists in the diagnosis and management of minor ailments.
The scientific content of the application was based on the information in the symptoms in the pharmacy and British Nati
Judo has witnessed tremendous developments since its inception until the present day. It has been distinguished by its adaptation to the various challenges it has faced throughout the ages. Judo is one of the sports that have been affected by social, technological and cultural changes. These changes reflect its transformation from the traditional Japanese martial art to a global sport practiced. All over the world, therefore, studying the historical development of judo is important, as it provides valuable insights into the development of martial arts over a century, by studying the origins, principles and techniques of judo for the period (1880 - 1980), and also enables us to gain an understanding A deeper understanding of how the art form
... Show MoreThe Messengers and the Imam of the God-fearing, Muhammad is God, his family, and all of his companions. As for what comes after... Fainting is one of the involuntary symptoms and states that occur to a person when carrying out his life’s tasks suddenly due to his loss of sense and movement, so he loses consciousness for a period of time that is short or may be long, and the person is held accountable and responsible for every moment of his life. He is required to perform duties specified by Sharia law, such as prayer, fasting, and Hajj...and fainting prevents him from performing these actions. We must consider the opinions of jurists and know the legal implications resulting from it. It was said that a person has a capacity that enable
... Show MoreThe paper proposes a methodology for predicting packet flow at the data plane in smart SDN based on the intelligent controller of spike neural networks(SNN). This methodology is applied to predict the subsequent step of the packet flow, consequently reducing the overcrowding that might happen. The centralized controller acts as a reactive controller for managing the clustering head process in the Software Defined Network data layer in the proposed model. The simulation results show the capability of Spike Neural Network controller in SDN control layer to improve the (QoS) in the whole network in terms of minimizing the packet loss ratio and increased the buffer utilization ratio.
The research seeks to study the subject (Media separation: the Relationship of Arab Immigrants with the Media of the Countries of Diaspora/ Sweden as a model). Where this phenomenon, "problem" has not been subjected to an in-depth study to find out the causes of this media separation and its repercussions on the immigrant, whether in the problem of integration, or his opportunity to work, or adapt to live in the new society.
Separation is a kind of word that is rarely used in Arabic media studies, relevant, sometimes, to the meaning of “refraining from watching TV or listening to the radio or reading newspapers”. Sometimes, it means “not tuning to or using any form of media like radios or newspapers to be updated about what
... Show MoreThis study was conducted for evaluating the cytotoxic effect of heat stable enterotoxin a (STa) produced by enterotoxigenic Escherichia coli on the proliferation of primary cancer cell cultures, obtained from tumor samples that were collected from (13) cancer patients and as follows: (five colon cancer patients, two bladder cancer patients, two breast cancer patients, two stomach cancer patients and two lung cancer patients), and on normal cell line (rat embryonic fibroblast / REF) (in vitro) with the use of different concentrations starting from (1) mg/ml and ending with (0.0002) mg/ml by making two fold serial dilutions by using the 96- well microtiter plate, and in comparison with negative (PBS) and positive (MMC, at concentration
... Show MorePresent study was conducted in order to assess Slabiaat water quality by measuring some physical and chemical factors of river water, the study included a choice of three stations along of Slabiaat River in Samawa city, water samples collected a monthly during the period from September 2013 August 2014. The study involved measuring the Air & water temperatures, pH, Electrical conductivity, Total dissolved solids, Dissolved oxygen, Total hardness, calcium hardness, magnesium, turbidity, and some types of bacteria in River water. The study results showed that the values of air & water temperatures have ranged between (20.1-36.6)?C , (10-21.8) in Slabiaat River, respectively . pH values ranged between (6.6-8.7). Electrical conductivity in
... Show MoreThis research aims to know the role and impact of participation in the capabilities of human resources programs, and for the purpose of measuring it has been determined the dimensions of these two variables by relying on standards for this purpose, was chosen as the Ministry of Higher Education and Scientific Research / device supervision and scientific calendar as one of the important departments in the ministry and includes a large number of individuals at different organizational levels for the purpose of answering a questionnaire prepared for the purpose of measurement and access to the results and the achievement of the objectives of the research and which ha
... Show More