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.
يتطلب نظام الحماية الكاثودية للتيار القسري (ICCP) قياسات كميات منخفضة للغاية من الخصائص الكهربائية. استخدم العمل التجريبي الحالي وحدة مستشعر Adafruit INA219 للحصول على قيم الجهد والتيار وقدرة الحمل الافتراضي الذي يستهلك طاقة منخفضة جدًا تحاكي نظام ICCP. تكمن المشكلة الرئيسية في تكييف مستشعر INA219 مع بيئة LabVIEW بسبب عدم وجود مكتبة المستشعر هذا. تم تخصيص هذا العمل لتكييف وحدة استشعار Adafruit INA219 في بيئة LabVIEW من خلال إنشاء
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Abstract
The study discussed three areas in strategic thinking, namely, (patterns elements, outcomes) , this study aimed to measure extent to which strategic leaders have the type or types of patterns of strategic thinking, and measure the extent of their use of the elements of strategic thinking, and measurement of strategic thinking outcomes for managers at various levels , And to know the relationship between the modes of strategic thinking, elements and outcomes in organizations. the study included five banks and four hospitals and four colleges and universities, has been a research sample consisted of 168 individuals, distributed in positions (Director General , Director of Directorate , Director of
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The mathematical construction of an ecological model with a prey-predator relationship was done. It presumed that the prey consisted of a stage structure of juveniles and adults. While the adult prey species had the power to fight off the predator, the predator, and juvenile prey worked together to hunt them. Additionally, the effect of the harvest was considered on the prey. All the solution’s properties were discussed. All potential equilibrium points' local stability was tested. The prerequisites for persistence were established. Global stability was investigated using Lyapunov methods. It was found that the system underwent a saddle-node bifurcation near the coexistence equilibrium point while exhibiting a transcritical bifurcation
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Problem Statement: Despite the critical role of arm movement in freestyle swimming, many learners— specially female students at Baghdad University's College of Physical Education and Sport Sciences— face difficulties executing the pushing phase of the stroke correctly. This phase essential for generating propulsion and maintaining body coordination in water. Traditional teaching methods lack immediate feedback on the quality and force of arm movements, impeding effective motor learning and coordination. Approach: the researchers developed a custom-made device designed to measure the pressure force exerted by the palms during freestyle swimming. The device features pressure sensors attached both hands, a processor that analyzes the colle
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Nonalcoholic fatty liver disease in a group of Iraqi obese children attending children welfare teaching hospital
The research aims to find the impact of a proposed strategy according to the Luria model on realistic thinking among fifth-class scientific students and their achievement in mathematics. To achieve it, the experimental research method and the quasi-experimental design were used for two equal groups, one of them is a control group taught in traditional way and the other is an experimental one taught according to strategy based on Luria model. The research community represents the students of the fifth scientific class from the General Directorate of Education of Karkh First. The research sample (40) students were deliberately chosen and distributed equally between the two groups after making sure that they were equals in their previo
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Sphingolipids are key components of eukaryotic membranes, particularly the plasma membrane. The biosynthetic pathway for the formation of these lipid species is largely conserved. However, in contrast to mammals, which produce sphingomyelin, organisms such as the pathogenic fungi and protozoa synthesize inositol phosphorylceramide (IPC) as the primary phosphosphingolipid. The key step involves the reaction of ceramide and phosphatidylinositol catalysed by IPC synthase, an essential enzyme with no mammalian equivalent encoded by the AUR1 gene in yeast and recently identified functional orthologues in the pathogenic kinetoplastid protozoa. As such this enzyme represents a promising target for novel anti-fungal and anti-protozoal drugs. Given
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