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.
Show the greatness of Allah Almighty when contemplating the benefits of trees and plants in
Life in general and trees mentioned in the Koran in particular, do not have to meditate that
He acknowledges the greatness of the Almighty Creator, and his preference over man, that he is prepared for his livelihood
And give him what he can do in this life to the fullest.
The study also stressed the need to urge people to this great blessing trees
By preserving them and wasteful wastefulness.
The study also pointed to the need to guide people towards the aesthetics and improvements of
Look through and enjoy the beauty of trees, flowers, greenery and fruits ..
The objectives of the study were to identify the incidence rate and characteristics of adverse drug events (ADEs) in nursing homes (NHs) using the ADE trigger tool and to evaluate the relationships between resident and facility work system factors and incidence of ADEs using the System Engineering Initiative for Patient Safety (SEIPS) model. The study used 2 observational quantitative methods, retrospective resident chart extraction, and surveys. The participating staff included Directors of nursing, registered nurses, certified nurse assistants (CNAs). Data were collected from fall 2016 to spring 2017 from 11 NHs in 9 cities in Iowa. Binary logistic regression with generalized estimated equations was used to measure the association
... Show MoreIn data transmission a change in single bit in the received data may lead to miss understanding or a disaster. Each bit in the sent information has high priority especially with information such as the address of the receiver. The importance of error detection with each single change is a key issue in data transmission field.
The ordinary single parity detection method can detect odd number of errors efficiently, but fails with even number of errors. Other detection methods such as two-dimensional and checksum showed better results and failed to cope with the increasing number of errors.
Two novel methods were suggested to detect the binary bit change errors when transmitting data in a noisy media.Those methods were: 2D-Checksum me
Sustainability is a major demand and need pursued by cities in all areas of life due to the environmental, social and economic gains they provide, especially in the field of city planning and urban renewal projects that aim to integrate the past, present and future.
The research aims to evaluate the Haifa Street renewal project, and Al-Shawaka district, one of the Baghdad districts located next to Al-Karkh, was elected by comparing the sustainability indicators of urban renewal with the reality of the situation through a field survey and questionnaire form and focusing on the social and economic impacts and environmental for the project on the study area. To reach the most important conclusions and recommendations
... Show MoreLightweight concrete-filled tube (CFST) columns offer numerous benefits, such as reduced weight, enhanced resistance to buckling, improved structural performance, and the ability to endure cyclic loading. This study considered key research on the structural behavior of CFST columns, covering various topics, including lightweight concrete, methods of concrete placement within steel tubes, and CFST columns with and without shear connectors. The literature review reveals that while several researchers have explored the use of shear connectors as a load-transfer mechanism in CFST columns, there is no consensus on the design methodology for connector resistance. Shear connectors signifi
Three types of zeolite A were prepared from Iraqi kaoline which are 3A, 4A and 5A by ion exchange method .They were characterized by XRD and atomic absorption techniques .They were used as adsorbents to examine their applicability for H2S adsorption .The adsorption process was performed in a static form and constant volume system which constructed from stainless steel .The effect of zeolite type and temperature on the adsorption properties of H2S at -5 , 25 and 55 oC was studied .The zeolite type 5A has the highest adsorption value (79.384 µmol/g ) and the three types may be arranged in a sequence toward H2S adsorption as 5 A> 4A>3A .The amount of H2S adsorbed increased as temperature decreased from 55 to -5 for all samples. Langmuir , Fre
... Show MoreAbstract: Plastic pollution is a major issue of the current century. This waste is found in seas, freshwater, lakes, rivers, coastal areas, and soil. In this article, this article discusses the various sources of plastic pollution, including the manufacturing process of plastics and the addition of materials to improve their properties, as well as the use of single-use plastics that are not recyclable, in addition to burning and illegal waste disposal in the open. The impact on public health is through human exposure to toxins from plastics in the environment directly through inhaling dust and fumes, consuming contaminated food and drink, and skin contact. Indirectly, when marine creatures consume microplastics, they will find their way
... Show MoreBackground: This study aimed to evaluate the outcome of long-term results of dacryocystorhinostomy (DCR) techniques in specialized eye care center in Iraq.
Subjects and Method: This is a prospective study of 650 patients from July 2014 to July 2019 with nasolacrimal duct obstruction in Ibn Al Haitham Eye Teaching Hospital. A preoperative questionnaire was done, then one month, three months, six months and one year postoperatively. The success of surgery defined as follow; Absence of epiphora completely, Resolve of dacryocele or mucocele or any new attack of daryocystitis, Appearance of fluorescein dye from nose in fluorescein disappearance test, Successful irriga
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