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.
The principal concern of this study is Disjunct and Conjunct adverbials in the
English language. The study sets out to explore and clarify the types, nature and
structure of disjuncts and conjuncts. It also aims at testing student's performance to
evaluate the use and usage of the disjuncts and conjuncts in their written performance.
Two tests, accordingly, were given to some fifty students of at the Dept. of English, at
the college of languages (third and fourth stages) in the University of Sulaimani. The
hypothesis that the study was based on are those students use disjuncts and conjuncts
hardly enough in their writings and when doing so, they generally tend to stick only to
the most commonly used and familiar o
The influence of process speed (PS) and tillage depth (TD) , on growth of corn (Zea mays L) yield, for Maha cultivar, were tested at two ranges of PS of 2.483 and 4.011 km.hr-1, and three ranges of TD of 15,20 and 25cm. The experiments were conducted in a factorial experiment under complete randomized design with three replications. The results showed that the PS of 2.483 km.hr-1 was significantly better than the PS of 4.011km.hr-1 in all studied conditions. The , slippage ratio (SR) and the machine efficiency (ME), the physical soil characteristics represented by the soil density and porosity (SBD and TSP), and the plant characteristics represented the roots dry weight, PVI and the crop productivity (CP), except adjective of the fu
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This study aims to answer a significant problem of social sciences and philosophy: How do we construct an institutional reality such as diplomacy with an objective recognizable existence? The study assumes that the ability to build institutional reality is based on our biological capacity, as it takes different forms in all the institutions we construct. The study takes the theory of the American philosopher John Searle as an approach to examining the assumption. The study sums up important findings; cultures, although they share the biological capacity on which they produce institutional realities, differ in the form of the value standards on which the institutional realities are based. The study recommends the need of Arab social resea
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Hands have consistently been an important vehicle in the transmission of disease (1). Thus, thorough hand-washing remains the single most important factor in preventing infection specially in hospitals and labs.Twenty-nine non-clinical volunteers (do not work or come in contact with a clinical or hospital setting) that lacked visible skin injuries, eczema or apparent skin disease were used, those subjects were all tested by a material of each of the three used in the study weekly and laboratory tests were done pre- and post washing.All three material were effective , Eugenol extract as effective as the bar and lotion soap. And this was confirmed statistically.Eugenol has a great antibacterial action even in small concentration and t
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Objective: to evaluate the increase in weight after biological agents and the association of weight gain with the body mass index among a sample of patients attending Baghdad Teaching Hospital Methods: A prospective study is carried out in Baghdad teaching hospital biological units and outpatient clinic of rheumatology for a period of one year starting On April 2015 and ending on March 2016. 120 patients were included in the study 40 psoriatic arthritis .40 ankylosing spondylitis and 40 rheumatoid arthritis Results : The study findings indicate that significance differences are seen regarding weight gain and b
Background: Hypertension is probably the most important public health problem around the world. People with periodontal disease may be at greater risk of hypertension. The inflammatory effects of periodontal disease help to promote endothelial dysfunction in arteries which may lead to changes in blood pressure. Salivary MMP-8 has been associated with both periodontal disease and prevalent hypertension. Aim of study: This study was conducted to measure salivary matrix metalloproteinase - 8, in relation to periodontal health condition among a group of patients with hypertension in comparison with control group. Materials and methods: Ninety subjects, aged 45-50 years old were included in this study, seeking treatment for chest pain in Ibn-A
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Artificial intelligence (AI) offers significant benefits to biomedical research and academic writing. Nevertheless, using AI-powered writing aid tools has prompted worries about excessive dependence on these tools and their possible influence on writing proficiency. The current study aimed to explore the academic staff’s perspectives on the impact of AI on academic writing. This qualitative study incorporated in-person interviews with academic faculty members. The interviews were conducted in a semi-structured manner, using a predetermined interview guide consisting of open-ended questions. The interviews were done in person with the participants from May to November 2023. The data was analyzed using thematic analysis. Ten academics aged
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Contemporary arts have achieved, in accordance with the transition of concepts, a new logic in presentation and expression in general, and specifically in the field of ceramic art. The shift towards the logic of rejection and subversion of prevailing methods, which have been almost a constant foundation for a long period, has directly influenced the direction of visual arts in the contemporary world.
The growth and cultural transformations that the world has witnessed after the two World Wars have produced cognitive shifts based on strategies that diverge from the dominant culture. These approaches vary according to existential needs, as the language of art has become conceptual and a medium for contemporary culture with its rapid an