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.
Breast cancer is one of the most important malignant diseases all over the world. The incidence of breast cancer is increasing around the world and it is still the leading cause of cancer mortality An Approximately 1.3 million new cases were diagnosed worldwide last year. With areas rising increasing, risk factors for breast cancer including obesity, early menarche, alcohol and smoking, environmental contamination and reduced or late birth rates become more prevalent. In Iraq, breast cancer ranks first among types of cancers diagnosed in women. This study was conducted on one hundred twenty women with breast cancer that was evaluated and investigated for the possible role of the risk factors on the development of breast cancer in females. T
... Show MoreThe impact of a proposal for the curriculum dictated by some of the barriers to the development of motor skillsA. M. D. Huda Ibrahim RezoukiM. M. Susan Salim DawoodIs the childhood of the most important and most fertile stage of basic education because of their significant impact in building a base on which the stated origin of sound in the early stages older age because the baby at this stage be very vulnerability to environmental factors different surroundings in which to leave their mark on his life in the stages of life other.The Gymnastics of sports long-term training, which begins between the ages very early relative to the rest of other games to reach the stage of the tournament from the age of 13-17 years almost to the women, this a
... Show MoreThe Arab realized that proverbs and their stories had a great literary and linguistic significance, accordingly, they collected them from their sources and wrote them down. Thus, researchers went in studying them in different directions. The aim of the present research is thus to study the stories of proverbs in the Holy Qur’an, Prophet’s hadiths, and in the sayings of Arabs. Such a study helps to show the extent of the relevance of their stories to the proverbs, their literary values, the points of convergence between them and what they highlight, and the extent of their proximity to reality. It further helps to determine the factors that contributed to the transformation of Quranic verses, Prophet’s hadiths, and some phrases of s
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In this paper, the dynamics of scavenger species predation of both susceptible and infected prey at different rates with prey refuge is mathematically proposed and studied. It is supposed that the disease was spread by direct contact between susceptible prey with infected prey described by Holling type-II infection function. The existence, uniqueness, and boundedness of the solution are investigated. The stability constraints of all equilibrium points are determined. In addition to establishing some sufficient conditions for global stability of them by using suitable Lyapunov functions. Finally, these theoretical results are shown and verified with numerical simulations.
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The past decades of the last century and until now have witnessed many crises in the housing sector, and these crises were the result of many problems that led to a weak quality and quantity of housing stock, especially for lowincome people, and Goal 11 of the Sustainable Development Goals states, "Make cities and human settlements inclusive, safe, and capable of enduring and being sustainable, we have prepared this research that attempts to answer the following question: Is the current empowerment in the housing sector real and efficient support for people with limited income? The research assumes that empowerment in the housing sector has an important and effective role in reducing housing problems, the research aims to reach the most imp
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The effects of using aqueous nanofluids containing covalently functionalized graphene nanoplatelets with triethanolamine (TEA-GNPs) as novel working fluids on the thermal performance of a flat-plate solar collector (FPSC) have been investigated. Water-based nanofluids with weight concentrations of 0.025%, 0.05%, 0.075%, and 0.1% of TEA-GNPs with specific surface areas of 300, 500, and 750 m2/g were prepared. An experimental setup was designed and built and a simulation program using MATLAB was developed. Experimental tests were performed using inlet fluid temperatures of 30, 40, and 50 °C; flow rates of 0.6, 1.0, and 1.4 kg/min; and heat flux intensities of 600, 800, and 1000 W/m2. The FPSC’s efficiency increased as the flow rate and hea
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The paper presents a highly accurate power flow solution, reducing the possibility of ending at local minima, by using Real-Coded Genetic Algorithm (RCGA) with system reduction and restoration. The proposed method (RCGA) is modified to reduce the total computing time by reducing the system in size to that of the generator buses, which, for any realistic system, will be smaller in number, and the load buses are eliminated. Then solving the power flow problem for the generator buses only by real-coded GA to calculate the voltage phase angles, whereas the voltage magnitudes are specified resulted in reduced computation time for the solution. Then the system is restored by calculating the voltages of the load buses in terms
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