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.
Ahmed ibn Imad ibn Yusuf al-Aqfhasi (808 AH / 1405 AD) is a small message that speaks about the Nile River in all its sides, despite its limited papers, but it is one of the manuscripts of the important geographical literature for its geographical, historical, religious and grammatical information. it was not limited to the information of the author alore, but taken from many sources below, which added to the importance of the fact that it has saved us the names of the sources that preceded him in mentioning this river with the names of its authors.The method of the Aqfhasi was characterized by scientific methodology in writing and clarity, with reference to some of the myths that people carried in their minds about the Nile River at tha
... Show MoreBackground: 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 MoreWe propose a new method for detecting the abnormality in cerebral tissues present within Magnetic Resonance Images (MRI). Present classifier is comprised of cerebral tissue extraction, image division into angular and distance span vectors, acquirement of four features for each portion and classification to ascertain the abnormality location. The threshold value and region of interest are discerned using operator input and Otsu algorithm. Novel brain slices image division is introduced via angular and distance span vectors of sizes 24˚ with 15 pixels. Rotation invariance of the angular span vector is determined. An automatic image categorization into normal and abnormal brain tissues is performed using Support Vector Machine (SVM). St
... Show MoreNovel has recently received the attention of readers and writers greatly, because of the role they play, and this indicates an important rule, which is whenever there is an art or creativity, there must be a respective criticism, and this criticism is certainly not less important than the author. So there are critics who have a prestigious literary position in the follow-up story development, and trying to describe the transformation of its elements. One of these critics is professor Fadhel Thamer, and who wants to approach one of the elements of the novel exploring, must stop on the visions of this critic about it , and that’s why we take the (character) element following the most important opinions of this critic about
... Show MoreWilliam Shakespeare's play Coriolanus explores the journey of power and the transformation of a skilled warrior into a statesman. This paper employs Machiavelli’s framework of pragmatic statecraft to analyse Coriolanus’s tragic failure as a political leader despite his unparalleled prowess as a Roman general. It analyses Coriolanus's political career, revealing how his military skills, while effective in warfare, do not translate into political success. The paper shows that Coriolanus’s contempt for performative politics, refusal to adopt civic diplomacy, and failure to soften aristocratic pride with populist appeal turn plebeians against him and alienate patricians. His upholding of martial honour — fostered by his mother Volumnia
... Show MoreThe management of anger is problematic for many people and it is a particularly important issue for persons with substance use disorders (SUD). The paper reviews the research studies dating back to 2005 on how to help persons with SUD manage anger. The literature reveals that various pharmaceutical and non-pharmacological approaches have been studied to help persons with SUD manage their anger. In chronic and lower risk situations non-pharmacological are the first line approaches, they include anger management training, cognitive-behavioral based treatments, exercising and relaxing, music therapy and empathy. Atypical antipsychotic and medications for opioid use disorders (MOUD) are also widely used. In acute and high risk of violen
... Show MoreListeria monocytogenes represents a critical foodborne pathogen causing listeriosis, a severe infection with mortality rates of 20- 30%. This comprehensive review integrates cutting-edge research from 2015-2024 with Iraqi epidemiological data to address significant knowledge gaps in regional surveillance and global comparative analysis. Recent discoveries include five novel Listeria species in 2021, revolutionary whole genome sequencing (WGS) surveillance systems, and advanced understanding of RNA-mediated regulation. Iraqi prevalence data reveals concerning patterns with rates ranging from 3.5% to 93.8% across different sample types, substantially higher than global averages. Critically, Iraqi isolates demonstrate alarming antibiotic resis
... Show MoreResearching the effects of the research and technological development contract, determining its extent and demarcating the boundaries of the obligations imposed in it, is the cornerstone of economic growth and development, because defining these obligations removes the ambiguity and conflict between interests, by stating the rights owed to each party and even trying to reconcile them, or impose protection by specifying guarantees that are compatible with the essence of the R&D contract, For the purpose of studying the subject thoroughly, we will divide this research into two sections. The first is devoted to identifying the parties to the research and technological development contract. As for the other topic, we will explain the obligation
... Show MoreCoronavirus: (COVID-19) is a recently discovered viral disease caused by a new strain of coronavirus.
The majority of patients with corona-virus infections will have a mild-moderate respiratory disease that recovers without special care. Most often, the elderly, and others with chronic medical conditions such as asthma, coronary disease, respiratory illness, and malignancy are seriously ill.
COVID-19 is spread mostly by salivary droplets or nasal secretions when an infected person coughs or sneezes.
COVID-19 causes severe acute respiratory illness (SARS-COV-2). The first incidence was recorded in Wuhan, China, in 2019. Since then it spreads leading to a pandemic.
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