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.
A novel azo dye was prepared by reacting the diazonium salt of 3-aminophenol with 8-hydroxyquinoline and subsequently used to prepare a series of Ni+2, Pd+2, Pt+4, and Cu+2 complexes. The ligand structure was characterized via1H-and 13C-nuclear magnetic resonance spectroscopy. The as-synthesized materials were characterized via Fourier-transform infrared, ultraviolet‒visible, and mass spectroscopy, as well as thermo gravimetry, differential scanning calorimetry, and elemental analysis. Conductivity, magnetic susceptibility, and the metal and chloride contents of the complexes were also determined. The ligand exhibited a trigonal geometry, whereas the Cu+2, Pd+2, Pt+4, and Ni+2 complexesexhibited tetrahedral, square planar, octahedral, and
... Show MoreService companies always working to increase their competitiveness and efficiency of the survival, growth and development in the present and the future, including insurance companies, so as to increase competition, especially after the emergence of the civil companies dramatically after 2003, has become the goal of recent studies carried out by the organizations is the human capital, because its success and excellence and achievement its objectives depends on the human, and this does not mean that the other components are not important, but also rely on the rights which has increased interest in the search for the way in which they can guide the behaviors and values and their own language in line with the organization's strategy an
... Show MoreEven though in recent decades a bulk of studies have been accomplished on the use of communicative language teaching (CLT) in English as a foreign language (EFL) environments, fairly a limited numbers of studies precisely dealt with investigating the attitudes of language teachers, students and supervisors concerning the principals of CLT in the context of Iraq. Henceforth, this study was designed to delve into the attitudes of teachers, learners and supervisors about the implementation. To this end, the study was accomplished using a mixed method design. The present study was carried out in two phases: designing and using a questionnaire plus interviewing the teachers, students and supervisors (51 language learners, 41 teachers and
... Show MoreThe planning for the formation of administrative policies and guidance through leadership are important things for managing administrative processes and sporting activities. As both contribute in the stability of the administrative conditions, and their development in the sport federations, whether they both were attentive about team and individual Olympic Games. The two researchers observe that, there is a variation in the correct way of application. Particularly in the formulation of administrative policies and leadership describing it as, modern management standards for both team and individual Olympic Games in the Iraqi National Olympic Committee. That led to cause a misconception and lack of clarity for some administrators of those uni
... Show MoreIntroduction/Aim. Seminal fluid analysis (SFA) plays a crucial role in helping infertility clinics diagnose the underlying reason of male infertility. The aim of the study was to investigate seminal fluid patterns of male partners of an infertile couple with apparently fertile female partners. Materials and methods. A cross-sectional study was conducted between January 2019 and December 2022. Patients were attending consultations for delayed conception for more than 12 months with apparently fertile female partner. Results. Four hundred fifty-three patients were included in the study. The distribution of patients according to age groups showed that 277 patients were young, aged 21 - 30 years (61%). Two hundred sixty-two (58%) patien
... Show MoreThis study depicts the removal of Manganese ions (Mn2+) from simulated wastewater by combined electrocoagulation/ electroflotation technologies. The effects of initial Mn concentration, current density (C.D.), electrolysis time, and different mesh numbers of stainless steel screen electrodes were investigated in a batch cell by adopting Taguchi experimental design to explore the optimum conditions for maximum removal efficiency of Mn. The results of multiple regression and signal to noise ratio (S/N) showed that the optimum conditions were Mn initial concentration of 100 ppm, C.D. of 4 mA/cm2, time of 120 min, and mesh no. of 30 (wire/inch). Also, the relative significance of each factor was attained by the analysis
... Show MoreThe current research aims to identify the effect of the learning mastery strategy using interactive learning as a therapeutic method on the achievement of secondary school students in mathematics. To achieve the research objective, the researcher selected second-grade middle school students at Al-Haybah Intermediate School for Boys and determined his research sample, which consisted of (77) students distributed into two sections: Section (A) the experimental group, with (38) students, and Section (B) the control group, with (39) students. The statistical equivalence of the two research sample groups was confirmed in the variables (intelligence test, previous achievement, and previous knowledge test). The researchers chose the par
... Show MoreDespite the great economic and commercial importance given to real estate by virtue of its view of the landscape or public roads, US courts have differed in their position on compensation for damages resulting from blocking that view or vision by public projects. Some courts compensated for such damages, other courts approved such compensation. Hence, this research came to shed light on the extent of the possibility of compensation for blocking the view or vision as a result of public projects, and the research has supported us with many judicial decisions.