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.
Since the time it emerged, stylistics, as a field of knowledge which combines both linguistics and literature, acquired a special status in the linguistic arena. Its significance in complementing the meaning delivered by linguistic means has been proven and acknowledged through numerous stylistic analytic attempts of different literary works and in different languages. The question put forward in this paper is whether or not the stylistic analysis can work as effectively on translated texts as it does on the original ones without having the results reached by the analysis distorting the meaning of the original text. An attempt to investigate this question is made herein by conducting a lexical stylistic analysi
... Show MoreBackground: Painful elbow joint over the lateral epicondyle especially with resisted wrist extension are common signs of lateral epicondyle tendinopathy, also called tennis elbow. Objective: To evaluate the clinical outcome of local platelet rich plasma (PRP) injection in patients with chronic tennis elbow compared with a steroid (Depomedrol 40 mg) injection. Methods: A total of 88 patients with chronic tennis elbow were treated at Al-Kindy Teaching Hospital and private clinics. All patients had chronic pain for about 24 weeks or more and had failed first line treatment. The patients dividing into two groups, Group A injected with PRP (n = 44), and group B injected with depomedrol 40 mg (n = 44). A good clinical result w
... Show MoreThe research talks about the most important challenges facing Muslim youth of their ideological, social and economic types, and the youth is facing several problems, the most important of which are the intellectual and social invasion to which the Islamic nation has been exposed and ways to address them from a Quranic perspective and find solutions to these problems and these challenges in accordance with Islamic Sharia and the texts of the Holy Quran. From three topics and several demands, during which the researcher tried to find solutions to each challenge through the verses of the Noble Qur’an.
This study confirms the ubiquitin conjugating enzyme 2B (Rad6) plays a significant role in the DNA repair pathway also because the ubiquitin-conjugating pathway. The DNA repair pathway could be a variety of bypass repair mechanism where the broken base pair is bypassed by permitting the replication fork to labor under the site of injury. This is often done by a shift mechanism wherever deoxyribonucleic acid enzyme - δ is switched with DNA enzyme - η (DNAP - η). Site of DNAP - η is massive enough to permit the broken ester to labor under, and so bypass the broken nucleotide. However, this is often potential solely through the involvement of Proliferating cell nuclear antigen (PCNA) that could be a processivity issue and it acts as a plat
... Show MoreA survey of haemoproteids among the eight species of Iraq rallids were carried out in the
middle, south, and west of Iraq. Two haemoproteods were recorded, Haeomproteus porzanae
(Galli-Valerio, 1907) as a new record for Iraq and the new species H. baghdadensis described
from Fulica atra L. collected in the middle of Iraq.
Background: Obesity represents a clear and
present danger to the health of children and
adolescents. Its prevalence among American
youth has doubled in the past 3 decades, and
there are now more overweight and obese
adults in the United States than adults of
normal weight.
Objectives of the study:
1- Finding whether screen watching among
adolescents has an effect on increasing
prevalence overweight and obesity.
2- The effect of other variables like physical
activity, eating in front of screen, eating under
stress on obesity and overweight among the
subjects sample.
Patients &Methods: During 3 months period a
cross sectional survey was conducted on 4
high schools at Baghdad with total
Background. In cases of spontaneous subarachnoid haemorrhage (SAH) with multiple intracranial aneurysms (MIAs) detected on angiography, some radiological clues assist in determining the site of a ruptured aneurysm which is bleeding is quite beneficial for the selection of the best treatment strategy. Case description. We report a case of a 60 years old patient who presented with spontaneous SAH, sellar hematoma, and three different aneurysms detected in angiography. Although the right Posterior communicating artery (PcomA) aneurysms showed Murphy’s teat on angiography intraoperatively, we discovered that the right superior hypophyseal aneurysm (SHA) was the source of the index bleeding. Both aneurysms were clipped successfully. Co
... Show MoreNon uniform channelization is a crucial task in cognitive radio receivers for obtaining separate channels from the digitized wideband input signal at different intervals of time. The two main requirements in the channelizer are reconfigurability and low complexity. In this paper, a reconfigurable architecture based on a combination of Improved Coefficient Decimation Method (ICDM) and Coefficient Interpolation Method (CIM) is proposed. The proposed Hybrid Coefficient Decimation-Interpolation Method (HCDIM) based filter bank (FB) is able to realize the same number of channels realized using (ICDM) but with a maximum decimation factor divided by the interpolation factor (L), which leads to less deterioration in stop band at
... Show MoreToday’s academics have a major hurdle in solving combinatorial problems in the actual world. It is nevertheless possible to use optimization techniques to find, design, and solve a genuine optimal solution to a particular problem, despite the limitations of the applied approach. A surge in interest in population-based optimization methodologies has spawned a plethora of new and improved approaches to a wide range of engineering problems. Optimizing test suites is a combinatorial testing challenge that has been demonstrated to be an extremely difficult combinatorial optimization limitation of the research. The authors have proposed an almost infallible method for selecting combinatorial test cases. It uses a hybrid whale–gray wol
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