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.
Toxic substances have been released into water supplies in recent decades because of fast industrialization and population growth. Fenton electrochemical process has been addressed to treat wastewater which is very popular because of its high efficiency and straightforward design. One of the advanced oxidation processes (AOPs) is electro-Fenton (EF) process, and electrode material significantly affects its performance. Nickel foam was chosen as the source of electro-generated hydrogen peroxide (H2O2) due to its good characteristics. In the present study, the main goals were to explore the effects of operation parameters (FeSO4 concentration, current density, and electrolysis time) on the catalytic perform
... Show MoreDepp and Heard's trial has reaped significant attention due to the domestic violence allegations directed towards each other. This paper sheds light on the repressed narrative beyond the mere words spoken aloud. It delves into an overlooked aspect, i.e., nonverbal communication. Previous studies focused on one or two categories of nonverbal communication. Therefore, the current study investigates the types and sub-types of nonverbal communication exhibited by both rivals within the courtroom setting. To examine the credibility and repressibility of nonverbal communication, the researchers have carefully watched (28) videos representing the whole trial's event. Some nonverbal communication was traced through the whole (28) videos fro
... Show MorePreserving the Past and Building the Future: A Sustainable Urban Plan for Mosul, Iraq
Rwanga (view) movement is a new Kurdish poetry movement. Some poets and modern storywriters published a manifest in 1970. They have made a group of changes in the content and appearance of Kurdish poetry. They were under the influence of western literature schools such as Surrealism, Dadaism and Existentialism. Likewise, the impact of the new Arabic literature that appeared by the end of 1960s on them was obvious as they were imitating such literatures. Nevertheless, the condition of Kurdistan at that time was in need of a new literature to express that new stage. Sherko Bekas was one of those poets who became the dynamo of the poetic movement in which the rebellion spirit was embodied in the modern way of dealing with culture, rhyme, rh
... Show MoreThe research aims to build a training program to develop the willpower in the kindergarten children. In order to achieve the objective of the research, the two researchers have developed a Training Program according to the following steps:
- Determining the general objective of the Training Program.
- Determining the behavioral objectives of the Training Program.
- Determining the content of the Training Program.
- Implementing the content of the Training Program sessions.
- Evaluating the Training Program.
The training program consisted of (15) sessions, each session included a set of parts (title, general objective, methods, time and place to implement the sessions, behavioral goals, tool
... Show MoreMembrane distillation (MD) is a hopeful desalination technique for brine (salty) water. In this research, Direct Contact Membrane Distillation (DCMD) and Air Gap Membrane Distillation (AGMD) will be used. The sample used is from Shat Al –Arab water (TDS=2430 mg/l). A polyvinylidene fluoride (PVDF) flat sheet membrane was used as a flat sheet form with a plate and frame cell. Several parameters were studied, such as; operation time, feed temperature, permeate temperature, feed flow rate. The results showed that with time, the flux decreases because of the accumulated fouling and scaling on the membrane surface. Feed temperature and feed flow rate had a positive effect on the permeate flux, while permeate temperatu
... Show MoreIn this study, ultraviolet (UV), ozone techniques with hydrogen peroxide oxidant were used to treat the wastewater which is produced from South Baghdad Power Station using lab-scale system. From UV-H2O2 experiments, it was shown that the optimum exposure time was 80 min. At this time, the highest removal percentages of oil, COD, and TOC were 84.69 %, 56.33 % and 50 % respectively. Effect of pH on the contaminants removing was studied in the range of (2-12). The best oil, COD, and TOC removal percentages (69.38 %, 70 % and 52 %) using H2O2/UV were at pH=12. H2O2/ozone experiments exhibited better performance compared to
... Show MoreIntroduction: Cerebral hydatid disease (CHD) is rare and the multiple-cystic variety is even rarer. In this paper, we report a case of multiple CHD and explore a possible link with a preceding spontaneous intracerebral haemorrhage (ICH). Case presentation: A 27-year old gentleman with a history of surgically-evacuated, spontaneous ICH presented with severe headache, left-sided weakness - Medical Research Council (MRC) grade II - and recurrent tonic-clonic seizures, while on a full dose of anti-epileptic medication. Brain magnetic resonance imaging (MRI) scans showed multiple intra-axial cystic lesions in the right hemisphere. The cysts were removed intact using Dowling’s technique through a large temporoparietal crani
... Show MoreBackground: As the development of zirconia crown using CAD/CAM technology, the usage of full zirconia crown is gradually increased. The aim of this in-vitro study was to evaluate and contrast the vertical marginal fit of single all-ceramic translucent zirconia crowns constructed from different brands translucent zirconia blanks. Materials and Methods: An acrylic resin model of a left maxillary premolar was prepared all around the tooth with (1 mm) depth and 3D scanning to get fifteen STL files, then distributed into three groups (Imes-icor, Whitepeaks and Dental direct), 3D scanning and milling machine by Imes-icor CAD/CAM devise. Marginal gaps along vertical planes were measured at four indentations at the (mid mesial, mid distal, mid bucc
... Show Moreأثر تنوع الرؤى الاخراجية للاتجاهات والحركات المسرحية المعاصرة في أتساعالاشتراطات الجمالية لبنية الخطاب المسرحي + الامر الذي ادى الى انزياح مكوناتالعرض وعناصره ؛ ومنها المنظومة السردية للنص التي شكلت في بدايات المسرحجغرافية العرض المسرحي والمرتكز النظري والفكري الذي يمد العرض المسرحي أغلبتدفقه الجمالي وعنصر أستعلائي لعناصر العرض الاخرى ؛ وضمن التطورات اللاحقةأنسحب المخرج المسرحي من سطوة البنية النص
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