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 surgeryKeywords: Non-surgical treatment of anal fissure, fissure in ano, sphicterotomy,botulinum toxin in anal fissures, glyceryl trinitrate. Chemical sphincteratomy, pharmacological sphincteratomy.
The history of the Olympic movement in Iraq is a rich history that reflects the interest of Iraqi governments and society in sports, the social and economic conditions, and international relations, and highlights the intersection of sports and politics and the impact of global events on local sports development. Therefore, providing a valuable insight into the reality of the participation and results achieved by Iraq in the Olympic Games for the period under study helps in giving a broader understanding of Iraq’s position in the global sports community. The research aims to document the important events in the development of the Olympic movement in Iraq for the period (1929-2000) and explore the formation and development of the Iraqi Olym
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The present study is a linguistic study of comment clauses in the American Series „Friends‟ .Comment clauses refer to those clauses which comment on the content of the main clause or the attitude of the speaker towards the way of speaking .The problem of this study is to answer the following questions ; what types of comment clauses can be used in the face- to –face conversations , for what functions these comment clauses could be used , and how these comment clauses are used by the participants of these conversations . This study is a qualitative one . The study aims to investigate the types of comment clauses used in the American Series “Friends‟. The study also aims to investigate the pragmatic functions of these comment clause
... Show MoreMorphologies of ceramic hollow fiber membranes prepared by a combined phase-inversion and sintering method were studied. The organic binder spinning solution containing suspended Al₂O₃ powders was spun to a hollow fiber precursor, which was then sintered at elevated temperatures( 300 ˚C, 1400 ˚C, 25 ˚C) in order to obtain the Al₂O₃ hollow fiber membranes. The spinning solution consisted of polyether sulfone (PES), N-methyl-2-pyrrolidone (NMP), which were used as polymer binder, solvent, respectively. The prepared Al₂O₃ hollow fiber membranes were characterized by a scanning electron microscope (SEM). It is believed that finger-like void formation in asymmetric ceramic membranes is initiated by hydrodynamically unstable vis
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Phenol condensed with β-keto esters via Pechmann condensation to form derivatives of Coumarin in various reaction conditions by two ways. Present paper is comparative study of synthesis Coumarin with the yield of product , reaction time and reaction conditions.
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Plagiarism is becoming more of a problem in academics. It’s made worse by the ease with which a wide range of resources can be found on the internet, as well as the ease with which they can be copied and pasted. It is academic theft since the perpetrator has ”taken” and presented the work of others as his or her own. Manual detection of plagiarism by a human being is difficult, imprecise, and time-consuming because it is difficult for anyone to compare their work to current data. Plagiarism is a big problem in higher education, and it can happen on any topic. Plagiarism detection has been studied in many scientific articles, and methods for recognition have been created utilizing the Plagiarism analysis, Authorship identification, and
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The present study cognitive aims to investigate the negation phenomenon in American political discourse under Critical Discourse Analysis (CDA) principles. The research sample includes two speeches given by Clinton and Trump in their election campaigns in 2016. Since the nature of the study follows the social-cognitive approach, the researcher adopted two models of analysis to achieve the study’s objectives: First, the theoretical framework of MST (developed by Fauconnier (1994), Fauconnier and Sweetser (1996) to examine meaning construction resulting from building different levels of negative mental spaces by two different genders the selected speeches. Second, pragmatic model to examine the role of gender from the functional per
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