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.
Background: The world is in front of two emerging problems being scarceness of virgin re-sources for bioactive materials and the gathering of waste production. Employment of the surplus waste in the mainstream production can resolve these problems. The current study aimed to prepare and characterize a natural composite CaO-SiO2 based bioactive material derived from naturally sustained raw materials. Then deposit this innovative novel bioactive coating composite materials overlying Yttria-stabilized tetragonal zirconia substrate. Mate-rials and method; Hen eggshell-derived calcium carbonate and rice husk-derived silica were extracted from natural resources to prepare the composite coating material. The manufac-tured powder was characterized
... Show MoreBackground: Implant stability is a mandatory factor for dental implant (DI) osseointegration and long-term success. The aim of this study was to evaluate the effect of implant length, diameter, and recipient jaw on the pre- and post-functional loading stability. Materials and methods: This study included 17 healthy patients with an age range of 24-61 years. Twenty-two DI were inserted into healed extraction sockets to replace missing tooth/ teeth in premolar and molar regions in upper and lower jaws. Implant stability was measured for each implant and was recorded as implant stability quotient (ISQ) immediately (ISQ0), and at 8 (ISQ8) and 12 (ISQ12) weeks postoperatively, as well as post-functional loading (ISQPFL). The pattern of implant
... Show MoreBackground: Survey of the occlusion in population groups usually include in their objections the academic assessment of occlusal feature, the planning resources for public health treatment programmers, the comparison of different population and the screening of groups for orthodontic treatment. Likewise a thorough investigation of the occurrence of malocclusions among school–students would be of major importance in the planning of orthodontic treatment in the public dental health services. For this purpose it is necessary to have detailed information on the prevalence of individual malocclusion among boys and girls at different ages distributed regionally, and moreover, an analysis of the need for orthodontic treatment in the different sc
... Show MoreThe purpose of this study is to show the constants and variables geography in Russian
policy in light of variables geostrategic witnessed by the world, especially after the collapse
of the Soviet Union and the disintegration to fifteen Republic became the Russian Federation
and the heir to the Soviet Union, Geography particularly important because the impact of its
data in policy making less change ofothers, and explain the political choices cannot achieve
security through its relationship constants geographical (natural or human) paint forms of
economic activity and determine the points they national security. issue is the geographical
this or that country is determined by its policy also specifies the way in which
Henrik Ibsen is considered one of the greatest writers on society and its problems in the modern era, as his works deal with society in all its forms in a realistic way, in which he presents the motives and consequences of social problems and their impact on society to study these problems through them to and propose solutions through theatre. Most of his writings were very serious about addressing these social issues. The method of collecting information in the study came through reviewing a group of sources related to realistic theater and social theory, then reading the plays covered in a critical and analytical reading. Based on that, the method of writing this study came and used a group of sources that directly relate to the s
... Show MoreVarious literary studies have investigated the psychological, social and cultural effects of traumatic events. They give voice to traumatised victims and enable them to convey and confront their traumas. However, these studies present a one-sided view, concentrating largely on the presentation of trauma in the industrial societies of the Western world. Recently, increasing attention has been devoted to identifying and depicting the forms and types of trauma that have been experienced in marginalised and neglected societies, such as the Iraqi society. Iraq has witnessed the unexpected fall of a brutal dictatorship, Western invasion and an unprecedented rise of sectarian discourses. This extreme violence has deeply affected many aspec
... Show MoreBackground: Immune thrombocytopenia is an immune-related disorder that causes an impairment in platelet production and stimulates platelet destruction, causing variable bleeding symptoms. Objective: This study focuses on refractory immune thrombocytopenic purpura patients on romiplostim treatment and their level of illness perception related to treatment response. Method: A cross-sectional study was conducted from May 1st, 2025, to August 1st, 2025. Brief Illness Perception Questionnaires were administered to 84 patients with ITP to collect the data. The study took place at the Hematology and Bone Marrow Transplant Center, Medical City, Baghdad, Iraq. Results: The romiplostim response rate is 21 (25.0%), while the partial response rate is 4
... Show MoreBackground In rheumatoid arthritis, your immune system attacks the tissue lining the joints on both sides of your body. Other parts of the body may also be affected. Unsure of the exact cause. Two separate genes termed IL12A (p35) and IL12 encode the heterodimeric cytokine known as IL12 (p40). Several different hematopoietic cell types can have several different hematopoietic cell types that can generate antigen-presenting cells (APCs), including DCs and macrophages. Objectives This study aimed to investigate if the interleukin IL-12B gene's common polymorphisms in an Iraqi population were associated with RA. Material and methods Blood samples were taken from 70 Iraqi patients with RA illnesses and 30 Iraqi controls during the periods from
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