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 aerodynamic characteristics of general three-dimensional rectangular wings are considered using non-linear interaction between two-dimensional viscous-inviscid panel method and vortex ring method. The potential flow of a two-dimensional airfoil by the pioneering Hess & Smith method was used with viscous laminar, transition and turbulent boundary layer to solve flow about complex configuration of airfoils including stalling effect. Viterna method was used to extend the aerodynamic characteristics of the specified airfoil to high angles of attacks. A modified vortex ring method was used to find the circulation values along span wise direction of the wing and then interacted with sectional circulation obtained by Kutta-Joukowsky theorem of
... Show MoreMany approaches have been developed over time to counter the bioavailability limitations of poorly soluble drugs. With advances in nanotechnology in recent decades, this issue has been approached through the formulation of drugs as nanocrystals. Nanocrystals consist of pure drug(s) and a minimum of surface active agent(s) required for stabilization. They are carrier-free submicron colloidal drug delivery systems with a mean particle size typically in the range of 200 - 500 nm. By reducing particle size to nanoscale, the surface area available for dissolution is increased, and thus bioavailability is enhanced. Drug nanocrystals constitute a versatile formulation approach to enhance the pharmacokinetic and pharmacodynamic properties of poorly
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Traditionally, style is defined as the expressive, emotive or aesthetic emphasis added linguistically to the discourse with its meaning is the same. In the current study, however, style is defined as the linguistic choice that the language users can make for specific purposes.
This study, thus, aims at analyzing political Arabic and English speeches to find out whether there are differences of style between English and Arabic and whether the choices the language users make can show any traits of their psychological status.
To fulfill the above aims, the study hypothesizes that English and Arabic speeches can be analyzed stylistically and that there are stylistic difference
... Show MoreThe present study is a qualitative study that aims to investigate the way the Iraqi caricaturist,Dheaa Al-Hajjar uses caricatures to produce a satirical meaning humorously.Producing satire while at the same maintaining humor requires a creative thinking on the part of the caricaturist. Thus, the study examines the production of humorous satire in terms of creativity. The analysis is done from the cognitive linguistic point of view using Arthur Koestler's theory of bisociation as presented in his book The Act of Creation in 1964. The main principle on which the theory is based is that humor is created via linking (or bisociating in Koestler's terms) two habitually incompatible trains of thought in order to come up with a novel me
... Show MoreWorldwide, hundreds of millions of people have been infected with COVID-19 since December 2019; however, about 20% or less developed severe symptoms. The main aim of the current study was to assess the relationship between the severity of Covid-19 and different clinical and laboratory parameters. A total number of 466 Arabs have willingly joined this prospective cohort. Out of the total number, 297 subjects (63.7%) had negative COVID-19 tests, and thus, they were recruited as controls, while 169 subjects (36.3%) who tested positive for COVID-19 were enrolled as cases. Out of the total number of COVID-19 patients, 127 (75.15%) presented with mild symptoms, and 42 (24.85%) had severe symptoms. The age range for the partic
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This study seeks to examine the language context of the prominent Revolution’s poet, Moufdi Zakaria, in his anthology “ The Algerian Odyssey " )إلياذة الجزائر( in which he makes use of the Coranic terms explicitly and implicitly. Besides, it seeks to explore the content of his terms from a lexicographic and semantic point of view in their Islamic and human dimensions
This study has been developed axes of the search, including: Search (deliberative) language and idiomatically, and Description Language (b social phenomenon), and the definition of the theory of (acts of speech), and discussed the problem of the conflict between tradition and innovation, as defined objectively have a target aimed at reviving the deliberative thought when Arab scholars , and the balance between the actual done Arab and Western rhetoric, but Meet in intellectual necessity, a sober reading that preserve the Arab language prestige, and its position in the light of the growing tongue Sciences, as long as we have inherited minds unique, and heritage huge able to consolidate the Arab theory lingual in linguistics.
The heat exchanger is a device used to transfer heat energy between two fluids, hot and cold. In this work, an output feedback adaptive sliding mode controller is designed to control the temperature of the outlet cold water for plate heat exchanger. The measurement of the outlet cold temperature is the only information required. Hence, a sliding mode differentiator was designed to estimate the time derivative of outlet hot water temperature, which it is needed for constructing a sliding variable. The discontinuous gain value of the sliding mode controller is adapted according to a certain adaptation law. Two constraints which imposed on the volumetric flow rate of outlet cold (control input) were considered within the rules of the proposed
... Show MoreThe aim of this research is to show the importance of the effective use
of the internet in academic libraries; to improve the services and to increase
the competence of librarians.
The research has given some recommendations to improve the quality
of services and the need for cooperative network among academic libraries.
Background: Anti-vascular endothelial growth factors commonly used intravitreally for treatment of variable retinal disease worldwide, which help to regulate the upregulation of vascular endothelial growth factors due to ischemia or/and other retinal insult.
Objective: To review all cases of intravitreal bevacizumab given in the retinal unit of the Eye Specialty Private Hospital in Iraq from December 2015 to June 2016, pointing out the common indications.
Methods: A retrospective study including all cases of intravitreal injections of bevacizumab recorded at the Eye Specialty Private Hospital from December 2015 to June 2016 were retrieved. Age, sex, laterality, diagnosis
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