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 surgery Keywords: Non-surgical treatment of anal fissure, fissure in ano, sphicterotomy,botulinum toxin in anal fissures, glyceryl trinitrate. Chemical sphincteratomy, pharmacological sphincteratomy.
Surge pressure is supplemental pressure because of the movement of the pipes downward and the swab pressure is the pressure reduction as a result of the drill string's upward movement. Bottom hole pressure is reduced because of swabbing influence. An Investigation showed that the surge pressure has great importance for the circulation loss problem produced by unstable processes in the management pressure drilling (MPD) actions. Through Trip Margin there is an increase in the hydrostatic pressure of mud that compensates for the reduction of bottom pressure due to stop pumping and/or swabbing effect while pulling the pipe out of the hole. This overview shows suggested mathematical/numerical models for simulating surge pressure problems ins
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The current study included a review of the registration and description of the Theretra alecto Boi, 1827 (Levant hawk moth), samples were collected from various areas of the Baghdad belt and the provinces of the Middle Euphrates, confirmation in the description was on the most important parts of the body included the head and it's appendages, pronotum, wings as well as male and female genitalia. The morphological characteristics under study were enhanced by illustrations and images. Information on the locations and date of the collection was also confirmed. This study aims to identify the most important characteristics of the diagnosis of the species and the review of appearance variations, especially the analytical style of wings, coupling
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The current world seeks to supply the most of the fruits of human knowledge and tries hard to search for the most important scientific facts, programs, means and advanced devices in various fields, including the sports field, and among these means is the use of various and advanced training devices and programs for the purpose of achieving the desired goal, which is to reach the desired level, the basketball game is one of the sports that need high technology in training according to scientifically studied principles because it is one of the games that relate to the abundance of its variables, composition and speed of change, all of which require a technical and high training depth and the players ’possession of different physical charact
... Show MoreKE Sharquie, SA Al Mashhadani, AA Noaimi, RK Al-Hayani, SA Shubber, Iraqi Postgraduate Medical Journal, 2012 - Cited by 1
KE Sharquie, SA Al-Mashhadani, A A Noaimi, RK Al-Hayani, SA Shubber, Iraqi Journal of Community Medicine, 2017 - Cited by 1
Summary
The book (Fatah al-Rahman reveals what is ambiguous in the Qur’an), which is a book of verbal similarities that tries to touch the Qur’an expression, and the subtle differences between its expressions and expressions. It appeared when it appeared in many chapters, from which I chose to delete in monolithic letters such as Ba and Ta, and to heal and delete in non-monosymbols such as (that) and (may) and (no), so the search came to two chapters The first is for deleting the monolithic letters, and the second is for deleting non-monosyllabic letters, preceded by introductory discussions revolving around the linguistic and idiomatic definition of deletion, a brief translation of the
... Show MoreThe focus of this research revolves around the importance level of sialic acid in the reasoning of cases, including tumors and then evaluate the patient's response to treatment and its impact on the immune response there are a lot of evidence showing that parts Alkrbu ???????? in peptides sugary and glycoproteins play an important role in Alfalitin life and responsiveness
This research investigates the meanings and significance of the verse and the concluded educational purports. The expression “And in the heaven is your provision” signifies the deism of Allah. This research introduces the what have been said by Quran Explainers about meaning of Heaven & Provision. It introduces also the meaning of the sentence “which you are promised” and its concluded educational purports. This research discuses the role of educational institutions as well as the family and mosques in connecting Muslims and their children with the promise given by Allah.
Provision is guaranteed for all people if moral and material causes have been considered.
Key Words:
Purports – Educational – Co
... Show MoreIn this work the strain energy of tetrahedrane and its nitrogen substituted molecules were calculated by isodesmic reaction method according to DFT quantum chemical fashion, the used basis set was 6-31G/B3-LYP, in addition all structures were optimized by RM1 semi-empirical method. From the obtained data we estimate an empirical equation connect between strain energy of the molecule with charge functions represented by dipole moment of the molecule plus accumulated charge density involved within the tetrahedron frame plus the number of nitrogen atoms. The results indicate the charge spreading factors by polarization and processes are the most important factors in decreasing the strain energy.