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.
The irony pushes us to inquire about what is in the text of contradiction, irony, suspense, and other acts of paradox, as well as a departure from what is logical, or familiar, that attracts the attention of the addressee, and this is what drives us to introspect the text and interrogate it in order to get to know the intended product of the text or its real or metaphorical intent. On the other hand, the irony is more in the literary text than in the scientific texts. Therefore, critics add the word literature to it in their definition.
As it is represented by the paradox, we will seek to study the paradox of the title and the problematic that it may pose as the beginning of the text, and i
... Show MoreA water resources management for earthen canal/stream is introduced through creating a combination procedure between a field study and the scientific analytical concepts that distinguish the hydraulic problems on this type of stream with using the facilities that are available in HECRAS software; aiming to point the solutions of these problems. Al Mahawil stream is an earthen canal which is subjected to periodic changes in cross sections due to scour, deposition, and incorrect periodic dredging processes due to growth of the Ceratophyllum plants and weeds on the bed and banks of the stream; which affect the characteristics of the flow. This research aims to present a strategy of water resources management through a field study that conducte
... Show MoreThe project has been described the design and construction of a reliable optical testing platform used for evaluate the reflectivity of metal surfaces treated with special paintings required for laser beam attenuation. The platform comprises an Nd-YAG laser system which has been designed and fabricated with specifications to be compatible with their corresponding in laser range finder transmitters used for various applications. The reflectivity of various attenuating paintings, at different detection angles, has been observed. Moreover, the variation of the reflected energy with painting type and metal type to be painted has been studied experimentally. Results illustrated the existence of a definite angle, at which the reflectivity was max
... Show MoreThis study synthesized zeolite 4A, and hierarchical composite structure consisting of zeolite 4A- carbon were successfully prepared. Hydrothermal method was used to grow a layer of zeolite 4A over porous carbon surfaces to enhance mass transfer and increase surface area of zeolite. The products then were used to remove radioactive cesium137Cs from liquid wastewater. Iraqi dates leaves midribs (DM) were used as locally available agricultural waste to prepare low- cost porous carbon, using carbonization method in tubular furnace at 900C for two hours. Hierarchical porous structures including zeolite are prepared by mechanically activating the carbon surface via Ultrasonicating nanoparticles suspension of ground zeolite type 4A.F
... Show MoreTillage appearance device is mechanical, electric-electronic design, getting Patent from the Central Organization for Standardization and Quality Control – Industrial Property Department - Ministry of Planning – The Republic of IRAQ under number Patent 3876 in 20 / 4 / 2014, calculates the number of clods per area by Tillage appearance device, This is done through the generation electrical impulses are sent to the controlled accurate calculates number clods required space and shows the result on the screen in order to see the tillage view per area. Three factor used in these experiment, first factor represents forward speed of tractor three levels (3.5, 4.5, and 5.5 km/h), second factor represent soil moisture content at two levels (14
... Show MoreAims: The present study aims at assessing mothers’ knowledge of breastfeeding in Kirkuk governorate,
besides determining the relationship between mothers’ knowledge and some of their demographic
attributes.
Methodolgy: A descriptive study was used the assessment approach and applied on mothers in Kirkuk
governorate from January 15th 2011 to July 25th
, 2011. Non-probability sampling a convenience sample of
(72) mothers, attending pediatric general hospital in Kirkuk governorate for following up the health status
of their children, was selected for the purpose of the study. A questionnaire was developed for the
purpose of the study. It was comprised of two parts; the first part includes the mothers' demographic
This study aims at discussing how gender differences might affect communication among people. For this purpose, several TV interviews are selected and examined on the discourse level. Developing a model of analysis ,is found that certain linguistics have been used by male speakers ,whereas different aspects have been utilized my female speakers like deictic expressions and lexical items of emotion and delicacy .
Suggestive ambiguity is a strategy of defense and maneuvering as it provides the speaker both protection and function. To put it differently, it helps the speaker to say whatever he likes and at the same time gives his opponents and friends the interpretation they desire. This is possible due to the flexibility of the linguistic expressions that the speaker uses. To be more clear, the context of situation, peoples' background and world knowledge interact with the significance of the linguistic expressions reaching an allusive situation where two interpretations, positive and negative, are available to the addressees. Such situation enables the addressers to implicate different ideas or messages, accusations, inciting violence, etc. The pres
... Show MoreBack ground: The innervations of the pineal
gland from the superior cervical ganglion have
shown some form of a chromatolysis reaction.
Objective:
1-Tracing the innervations of the pineal gland by
removing the target tissue (the pineal gland in
this study) i.e. (pinealoctomy) and removal of the
superior cervical ganglion i.e. (ganglionectomy).
2- The localization and total number of the
neurons which project into the rat pineal gland
3-The effect of pinealoctomy on the SCG after a
different time interval.
Methods: Twenty five albino rats were used in
this study, Pinealoctomy was done, then after a
different time interval ganglionectomy was done,
in order to study the Chromatolysis in their cel