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.
Background: Multiple sclerosis is a chronic heterogeneous demyelinating axonal and inflammatory disease involving the Central Nervous System [CNS] white matter with a possibility of gray matter involvement in which the insulating covers of nerve cells in the brain and spinal cord are damaged. This damage disrupts the ability of parts of the nervous system to communicate, resulting in a wide range of signs and symptoms. Cerebral venous insufficiency theory was raised as a possible etiology for the disease at 2008 by Zamboni an Italian cardiothoracic surgeon. This theory was defeated by Multiple Sclerosis[ MS] researchers and scientists who thought that the disease is an autoimmune rather than vascular.
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... Show MoreIn this paper a system is designed on an FPGA using a Nios II soft-core processor, to detect the colour of a specific surface and moving a robot arm accordingly. The surface being detected is bounded by a starting mark and an ending mark, to define the region of interest. The surface is also divided into sections as rows and columns and each section can have any colour. Such a system has so many uses like for example warehouses or even in stores where their storing areas can be divided to sections and each section is coloured and a robot arm collects objects from these sections according to the section’s colour also the robot arm can organize objects in sections according to the section’s colour.
Researchers are interested in the issue of children abuse and they look for its cause in the past and present. Their interest is limited to identifying penal liability which is caused by children abuse away from focusing on civil liability. So, the study is going to clarify the parents' responsibility for children abuse rather than civil liability of the medic in case he wouldn’t notify the authorities about the case according to the American law rules and the attitude of Iraqi law rather than some judicial application of civil cases that were exposed to American judiciary concerning children abuse.
In recent years, there has been a rise in interest in the study of antibiotic occurrence in the aquatic environment due to the negative consequences of prolonged exposure and the potential for bacterial antibiotic resistance. Most antibiotic residues from treated wastewater end up in the aquatic environment as they are not eliminated in facilities that treat wastewater. Antibiotics must be identified in influent and effluent wastewater using reliable analytical techniques for several reasons. Firstly, monitoring antibiotic presence in aquatic environments. Secondly, assessing environmental risks, computing wastewater treatment plant removal efficiencies, and estimating antibiotic consumption. Therefore, this work aims to provide an overview
... Show MoreThis paper includes a comparison between denoising techniques by using statistical approach, principal component analysis with local pixel grouping (PCA-LPG), this procedure is iterated second time to further improve the denoising performance, and other enhancement filters were used. Like adaptive Wiener low pass-filter to a grayscale image that has been degraded by constant power additive noise, based on statistics estimated from a local neighborhood of each pixel. Performs Median filter of the input noisy image, each output pixel contains the Median value in the M-by-N neighborhood around the corresponding pixel in the input image, Gaussian low pass-filter and Order-statistic filter also be used. Experimental results shows LPG-PCA method
... Show MoreNarcissism is a complicated phenomenon that can be reflected in the narcissist’s language. Investigating narcissism in terms of linguistics, and pragmatics in particular, does not seem to have been given its due attention, as this study reveals. Thus, this study is an endeavor to discover how narcissism is reflected in the American movie Big Eyes (2014). It is known for introducing narcissistic behaviors. This paper aims to identify the types, motivations, and pragmatic manifestations of narcissism in the selected movie. Three pragmatic theories are chosen to scrutinize narcissism in the data: Searle’s speech acts (1969), Grice’s maxims breaching (1975), and Culppeper’s impoliteness (1996). To cope with the nature of the
... Show MoreGeographic information system (GIS) is utilized in a variety of tasks such as, resource management, urban planning, emergency planning in case of accident, and rapid response etc. The aim of this study is to produce a digital map with the aid of GIS and a survey data. A survey data is conducted with Total Station technique on sanitary planning positions. The campus of Baghdad University is chosen to test the execution and accuracy of the results for sewer manholes locations. During the field survey, Total Station (Nikon Nivo) is used to identify the 3-D coordinates for each location. Finally, Geographical Information System (GIS) are utilized to present the digital map of the network sewer pipe line to the end users. Although Geographic Inf
... Show MoreAllah legislated marriage and made it dwelling, fellowship and mercy between
the two couples, Prophet Moh'd (peace of Allah and blessing be upon him) ordered a
husband to look after his wife, treat her with full charity and make love with here
every kindly. On the other hand, he ordered a wife to obey her husband and respect
him deeply, nevertheless, some obstacles may sometimes be appeared within the life
of their marriage, this may be caused by either a husband or a wife. This problem is
called lifely disobedience (AL-Noshooz).
In the other words, this means that a wife begins to hate her husband, refuse his orders
and not obey him.
In brief, they hate each other which leads to some marks appear in their
m
The present study aimed at examining the factors that affect the choice of A major among a sample of BA fe(male) students at the levels 3-8 in King Abdulaziz University (KAU), in Jeddah, Saudi Arabia. To meet this objective, a descriptive survey method was used together with a questionnaire that consisted of 4 axes to answer the central question: What are the factors affecting the choice of a major at the university? Results have shown that the item that measured the students’ ability to choose the major ranked (First); it was concerned with the effect on the students' choice of his/her major in the university. On the last position and with respect to this effect came the professional tendencies and desires. Results have also shown tha
... Show MoreThis work includes a detailed description of the Leucostoma nigricorpuris sp. nov. from
Iraq. Locality, host plants and data of collection were given.