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.
A new class of higher derivatives for harmonic univalent functions defined by a generalized fractional integral operator inside an open unit disk E is the aim of this paper.
One of the main environmental problems which affect extensively the areas in the world is soil salinity. Traditional data collection methods are neither enough for considering this important environmental problem nor accurate for soil studies. Remote sensing data could overcome most of these problems. Although satellite images are commonly used for these studies, however there are still needs to find the best calibration between the data and real situations in each specified area. Landsat satellite (TM & ETM+) images have been analyzed to study soil pollution (Exacerbation of salinity in the soil without the use of abandoned agricultural for a long time) at west of Baghdad city of Iraqi country for the years 1990, 2001 & 2007. All of the th
... Show MoreA mathematical method with a new algorithm with the aid of Matlab language is proposed to compute the linear equivalence (or the recursion length) of the pseudo-random key-stream periodic sequences using Fourier transform. The proposed method enables the computation of the linear equivalence to determine the degree of the complexity of any binary or real periodic sequences produced from linear or nonlinear key-stream generators. The procedure can be used with comparatively greater computational ease and efficiency. The results of this algorithm are compared with Berlekamp-Massey (BM) method and good results are obtained where the results of the Fourier transform are more accurate than those of (BM) method for computing the linear equivalenc
... Show MoreThere are obstacles to high levels of hypertension awareness that are embedded in gender, income and lifestyle habits which need to be addressed leading to high levels of undiagnosed and uncontrolled hypertension. This study aimed to explore the various factors which affect hypertension awareness among a hypertensive population in a tertiary care hospital.
A quantitative study was conducted among hypertensive patients at a tertiary care hospital in Selangor, Malaysia. A validated and translated questionnaire was utilised as a data collection tool. Descriptive and inferential statistical analysis was done using SPSS version 25.
A thousand participants (female n=621, male n= 379) were recruited, and their
... Show MoreSheet piles are necessary with hydraulic structures as seepage cut-off to reduce the seepage. In this research, the computational work methodology was followed by building a numerical model using Geo-Studio program to check the efficiency of using concrete sheet piles as a cut-off or reducer for seepage with time if the sheet piles facing the drawdown technique. Al-Kifil regulator was chosen as a case study, an accurate model was built with a help of observed reading of the measuring devices, which was satisfactory and helped in checking the sheet piles efficiency. Through the study, three scenarios were adopted (with and without) drawdown technique, it was found that at the short time there's no effect of the drawdown technique on
... Show MoreThe present work is qualitative descriptive. It aims to examine the idiosyncratic schema when deciphering the selected violence-based panel from Nasser Ibrahim’s caricatures. The researchers accordingly adopted part of Sharifian’s (2011) Cultural Schema model, particularly that part that is concerned with the examining the micro/idiosyncratic level of understanding. The study has revealed that the participants have not only differed among themselves regarding the way a figure is being denotatively conceptualized, they also highlighted different exact conceptualizations for the same figure, such as: using various adjectives that reflect various levels of intensity, emphasizing the behavioral aspect or the appearance of the figure, ado
... Show MoreIn this study, pebble bed as an absorber and storage material was placed in a south facing, flat plate air-type solar collector at fixed tilt angle of (45°). The effect of this material and differ- ent parameters on collector efficiency has been investigated experimentally and
theoretically. Two operation modes were employed to study the performance of the solar air heater. An inte- grated mode of continuous operation of the system during the period of (11:00 am – 3:00 pm) and non-integrated mode in which the system stored the solar energy through the day then used the stored energy during the period of (3:00 pm – 8:00 pm). The results of parametric study in case of continuous operating showed that the maximum average temperatur
Rheumatoid arthritis (RA) is a chronic inflammatory disease associated with decreased antioxidant state .This study aim to investigate the status of oxidant/antioxidant in a sample of Iraqi patients with RA and the role of peroxynitrite and its natural scavenger uric acid in them .This case-controlled study was conducted at Baghdad teaching hospital /Baghdad from December 2010-May 2011 . Twenty-five patients with mean age 39 years and 25 apparently healthy subject as controls with mean age 29 years were included in the study .Investigations include estimation of serum levels of nitric oxide (NO) ,peroxynitrite (PN) , malondialdehyde (MDA) , and uric acid (UA) .Serum PN levels were significantly elevated in RA patients a
... Show More