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.
Characterization is commonly known in stylistics to be the cognitive process in the readers' minds when comprehending a fictional character in a literary work .In one approach, it is assumed that characters are the outcome of the interaction between the words in the text on the one hand and the contents of our heads on the other. This paper is an attempt to understand how characterization is achieved by applying Culpeper’s (2001) model which seems to be to present a method of analysis that is more objective and more systematic in analyzing characters. Two characters are selected for discussion; Ralph and Jack from Golding’s (1954) Lord of the Flies. The novel talks about the corruption of human beings and the capacity of evil th
... Show MoreThis study focused on benthic algae (epipelic and attached algae on concrete lining stream) in Bani-Hassan stream in Holly Karbala, Iraq. The qualitative and quantitative studies of benthic algae were done by collecting 240 samples from five sites in the study area for the period from December 2012 to November 2013. Also, the environmental variables of the stream were examined in term of temporary and spatial. The results showed that the stream was alkaline, hard, oligohaline and a well aerated. The total nitrogen to the total phosphorus (TN: TP) ratio indicates nitrogen limitation. 129 species of benthic algae belonging to 57 genera were identified. Bacillariophyceae (diatoms) was the predominant taxon (95 species) followed by Chlorophyce
... Show MoreLuminescent sensor membranes and sensor microplates are presented for continuous or high-throughput wide-range measurement of pH based on a europium probe.
This research was aimed to evaluate activity of Rosemary volatile oil and Nisin A in vivo and on B. cereus isolated from some canned meat products in vitro. The results showed that the activity of Rosemary volatile oil (2000 µg/ml) and Nisin A (350 µg\ml) attained to 27 and 19 mm inhibitory zone diameter respectively in well diffusion method. The viable plate count from samples of canned meat treated with effective concentration of Rosemary volatile oil and Nisin A were examined. The samples with Rosemary volatile oil was not showed any CFU/g after 9 days of preservation while sample with Nisin A and control observed 49 and 45 CFU/g respectively. In vivo experiment on mice, two weeks after oral dose of Rosemary volatile oil (2000
... Show MoreMeasurement of construction performance is essential to a clear image of the present situation. This monitoring by the management team is necessary to identify locations where performance is exceptionally excellent or poor and to identify the primary reasons so that the lessons gained may be exported to the firm and its progress strengthened. This research attempts to construct an integrated mathematical model utilizing one of the recent methodologies for dealing with the fuzzy representation of experts’ knowledge and judgment considering hesitancy called spherical fuzzy analytic hierarchy process (SFAHP) method to assess the contractor’s performance per the project performance pa
Nowadays, there is a trend to promote the use of natural materials in dentistry. One of these compounds that has lately grown significantly in relevance in clinical research is
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Reliable estimation of critical parameters such as hydrocarbon pore volume, water saturation, and recovery factor are essential for accurate reserve assessment. The inherent uncertainties associated with these parameters encompass a reasonable range of estimated recoverable volumes for single accumulations or projects. Incorporating this uncertainty range allows for a comprehensive understanding of potential outcomes and associated risks. In this study, we focus on the oil field located in the northern part of Iraq and employ a Monte Carlo based petrophysical uncertainty modeling approach. This method systematically considers various sources of error and utilizes effective interpretation techniques. Leveraging the current state of a
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