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.
This work presents a five-period chaotic system called the Duffing system, in which the effect of changing the initial conditions and system parameters d, g and w, on the behavior of the chaotic system, is studied. This work provides a complete analysis of system properties such as time series, attractors, and Fast Fourier Transformation Spectrum (FFT). The system shows periodic behavior when the initial conditions xi and yi equal 0.8 and 0, respectively, then the system becomes quasi-chaotic when the initial conditions xi and yi equal 0 and 0, and when the system parameters d, g and w equal 0.02, 8 and 0.09. Finally, the system exhibits hyperchaotic behavior at the first two conditions, 0 and 0, and the bandwidth of the chaotic
... Show MoreConcurrently with the technological development that the world is witnessing the crime of money laundering to evolve faster and with multiple methods and its economic, political and social impacts raised increasingly. And for phenomenon dangerous the international community in recent years is keen to be considered combating money laundering as a general indication whereby verification of the international response the stats and its banks and financial institutions with international requirements mandated in this aspect, so the increasing interest the governments of countries in the laws and procedures that contribute to the reduction of the phenomenon of money laundering and avoid legislation economy and the banking and financial sectors
... Show MoreIntroduction: An aneurysmal bone cyst are enigmatic lesion of unknown cause and presentation and are difficult to distinguish from other lesions, it is a benign, but expansible tumor like lesion that generally occurs in the long bones. An aneurysmal bone cyst arising from the flat bone like clavicle is rare . Case presentation: We report a 12-year-old girl child with an aneurysmal bone cyst of the lateral third of left clavicle treated with enblock resection. The pathologic findings confirmed the diagnosis of aneurysmal bone cyst. The patient has been followed up for one year with no evidence of recurrence . Conclusion: En bloc resection can be curative and provide good results for this rare type of clavicle tumour.
The support qualitative information regards as an additional step in the process of decision-making where the method following by companies to provide information help in the creation of value because it is very important to deliver information to investors about their stratigies and what happen truly inside the companies i.e. every case relating with the expectations of stockhotslder and the prices of markets depending on those expectation ,and if the matter isn’t that there will be lack of confidence thate couldn’t be backed again. The decisions of the investors effected by security ,economic ,political, psychological, emotional ,and financial factors .
... Show MoreThe present paper aims at investigating the linguistic image portrayed by UNICEF reports on the Iraqi child from a critical discourse analysis perspective during Covid19 pandemic (2020). The paper attempts to fill a gap in research literature concerning the linguistic construction of the Iraqi child by the UNICEF reports during the critical health crisis of Covid19. Van Leeuwen’s (2008) approach of social actor representation has been adopted for this purpose. From Van Leeuwen’s approach, the category of determination (single determination and overdetermination) has been selected to be the main analytical tool for its high compatibility with the set of objectives put forward to figure out how such a globally effective and
... Show MoreCholesteryl ester transfer protein gene contains some single nucleotide polymorphisms, which have been associated with serum high-density lipoprotein concentration and other lipoproteins. This study is done for determining of cholesteryl ester transfer protein polymorphism and evaluate its effect on serum lipid profile concentrations in some hyperlipidemic patients compared with healthy subjects in Salah Al-din governorate-Iraq. Blood samples were taken from (90) patients suffering from hyperlipidemia, and (70) samples that were apparently healthy controls. Serum lipid concentrations were measured by enzymatic assays. The polymorphism was genotyped using polymerase chain reaction restriction fragment length polymorphism analysis.&n
... Show MoreThe researchers reached many conclusions, the most important of which was the distinction of practitioners of sports activity with high degrees in the trait (social). At the same time, it was low in the trait (aggression –restraint-desisting) and non-practitioners were distinguished by sports activity with high degrees in the trait (aggression –restraint-desisting). In contrast, the degree was low in the trait (social), and there were significant differences in favor of practitioners of the activity of the athlete, Through the conclusions, the researchers recommend the need for university students to practice sports activities because of their positive impact on their health in general and on the deve
... Show MoreThe current paper was designed to find the possible synergic effect of EBV infection with the HPV-16 in Iraqi women suffering from cervical carcinoma. This retrospective study involved paraffinized blocks of two groups. The research included 30 carcinomatous cervical tissues and 15 samples from normal cervical biopsies. After sectioning using positively charged slides, immunohistochemistry (IHC) was performed to detect anti-Epstein Barr Virus LMP1 and Human papillomavirus type 16 primary antibodies. Sixty-three percentage (19 out of 30) of the studies group showed positive overexpression as shown in with a significant association of the expression with cervical cancer with a significant association (p = 0). The co-infection of the EBV and H
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