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.
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.
Racism changes its meaning, shape, purpose or function according to various factors such as time, place, motives, and backgrounds; among others. It seems, however, to have deep roots back in the history of mankind. Such a concept stems from a perceived difference with the other. It is fed by the feeling of being hierarchically superior in opposition to another party that is depicted as inferior. Since ancient times, racism is disguised in different forms and manifests itself on various levels. It is a truism that this ideology can be best presented via language.
Due to its negative implication, racism lends itself to a critical kind of research. As such, this paper is a critical pragmatic investigation for this phenomenon a
... Show MoreThe dyes Azo have a lengthy history and are a vital part of our daily lives. There are numerous potentials uses for these substances and their derivatives in various industries and environmental and biological research. In this study conversion of various azo compounds into other derivatives, complexes, and polymers was accomplished. This review included examining the chemistry reactions, synthesis, and applications of azo dye ligands and their complexes, mentioned spectral, analytical, thermal, and morphology methods of investigation, and confirmed by mass fragment mechanisms for some azo dyes and metal complexes. One of the aims of this review is to explain the role of these azo dye derivatives and the effect of metal complexes on leather
... Show MoreThe determination of aerodynamic coefficients by shell designers is a critical step in the development of any projectile design. Of particular interest is the determination of the aerodynamic coefficients at transonic speeds. It is in this speed regime that the critical aerodynamic behavior occurs and a rapid change in the aerodynamic coefficients is observed. Two-dimensional, transonic, flow field computations over projectiles have been made using Euler equations which were used for solution with no special treatment required. In this work a solution algorithm is based on finite difference MacCormack’s technique for solving mixed subsonic-supersonic flow problem. Details of the asymmetrically located shock waves on the projectiles hav
... Show MoreThe article considers a creolized text as a means of modern communication, describing its key verbal and visual components; the relationship of concepts polycode and creolized text has been shown; the universal basic image features have been called; the following kinds of creolized texts have been distinguished; it has been proved that the effective means of attracting the attention of the addressee is the use of expressive font features, which are divided into two groups: topographics (mechanisms of varying of areal syntagmatic of a text) and supragraphcs (change of typeface of font).
In the last few years, the Internet of Things (IoT) is gaining remarkable attention in both academic and industrial worlds. The main goal of the IoT is laying on describing everyday objects with different capabilities in an interconnected fashion to the Internet to share resources and to carry out the assigned tasks. Most of the IoT objects are heterogeneous in terms of the amount of energy, processing ability, memory storage, etc. However, one of the most important challenges facing the IoT networks is the energy-efficient task allocation. An efficient task allocation protocol in the IoT network should ensure the fair and efficient distribution of resources for all objects to collaborate dynamically with limited energy. The canonic
... Show MoreThe aim of the research is to identify the extent of the direct and indirect relationship of the population growth of the cities as a result of the urbanization process witnessed by the Arab region for the urban development of the city structures and their formative structures, changing the planning criteria of some cities and the extent of their changes in spatial and temporal dimensions and their relation to the standards of the western cities. In changing the concept of the modern Arab city, such as the emergence of new functional uses affecting the change in the pattern of formal formations of its urban fabric associated with its ancient morphology and distinctive human nature. The research seeks to identify the extent to which plann
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