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 absence of ecological perception in the local urbanization resulted in the lack of a clear conception of achieving sustainability in its simplest form in the urban reality and in the city of Baghdad in particular. The research assumes the possibility of achieving urban sustainability in Iraqi cities by applying the cities for the most effective methods to implemented ecological solutions and introducing appropriate urban planning tools and improve the living environment. The research focuses on the ability to define some aspects to achieve a sustainable local urban identity from global experiences. This was performed by proposing a scheduled theoretical framework, through which th
The dramatic series on television have a great impact on people’sattitudes towards dialects of language varieties, by relating theconceptual pictures or prototypes presented by series’ characters tothose dialects. This study aims to show the influence of TV series onIraqi university learners’ gender and age in relating positive ornegative semantic qualities to their dialects. To this end, 150 Iraqi EFLlearners have participated in this study to examine their attitudestowards Baghdadi, Mousli and Nasiriya dialects. The data arecollected by Lambert, Hodgson, Gardner, Fillenbaum's (1960)matched guise technique and then labeled by Willmorth’s (1988)subjective reaction test. A structured interview is conducted to supportthe data
... Show MoreWith the increasing rates of cancer worldwide, a great deal of scientific discourse is devoted to arguments and statements about cancer and its causes. Scientists from different fields try to seize any available chance to warn people of the risk of consuming and exposing to carcinogens that have, unfortunately, become essential parts of modern life. The present paper attempts to investigate the proximization strategy through which scientists construct carcinogen risk to enhance people’s preventive actions against these carcinogens. The paper targets the construction which depends on producing the conflict between the values of the people themselves and the contrasting values assigned to carcinogens. To achieve this aim, Cap’s (2
... Show MoreImage classification is the process of finding common features in images from various classes and applying them to categorize and label them. The main problem of the image classification process is the abundance of images, the high complexity of the data, and the shortage of labeled data, presenting the key obstacles in image classification. The cornerstone of image classification is evaluating the convolutional features retrieved from deep learning models and training them with machine learning classifiers. This study proposes a new approach of “hybrid learning” by combining deep learning with machine learning for image classification based on convolutional feature extraction using the VGG-16 deep learning model and seven class
... Show MoreReseach target the most important topic, is Activity and ProfitabilityIndictors Analysis for
Nationality and Iraqi Insurance Company, In order to stand on them ability to cover its risks
and explore the efficiency asset and its avialible resources using to determine them abilities to
profit generation from its insurance activity. The analysis was focus to examine their profit
and activity power, and test the significant differences aming them performance. Test 2
hypothese that is related and result it sign that the 2 company no has significant differences at
profitability and activity level. The research depend on coneclusion, recommended two
company to work at efficiency with cost element of insurance activity in or
Substantial research has been performed on Building Information Modeling (BIM) in various topics, for instance, the use and benefit of BIM in design, construction, sustainable environment building, and Facility assets over the past several years. Although there are various studies on these topics, Building Information Modeling (BIM) awareness through facilities management is still relatively poor. The researcher's interest is increased in BIM study is based heavily upon the perception that it can facilitate the exchange and reuse of information during various project phases. This property and others can be used in the Iraqi Construction industry to motivate the government to eliminate the change resistance to use innovat
... Show MoreThe anatomic characteristics of the leaves of 22 taxa of Stachys L. representing seven of the currently recognized sections distributed in northern Iraq, were examined. The study did not found any variations in the characteristics of the stomata system of the leaves.Therewere variations with a good taxonomic value in other anatomic characteristics.Thevariations in characters of the mesophyll tissue in S.kurdica var.brevidens Bom ex Bhattacharjeewas bifacial but in S.kurdica var.kurdica Boiss. & Hohen.was unifacial .The study also found that the taxa S.benthamiana Bioss., S.lanigera (Bornm.) Rech.f. andS.kotscyi Bioss. with 3 vascular bundles in the middle vein while the taxa S.ballotiformis Vatke., S.megalodonta Hausskn. &Bo
... Show MoreThe clinical response to natalizumab in patients with multiple sclerosis (MS) may be significantly influenced by genetic variation. Mutations in genes related to the drug’s mechanism of action or the pathological milieu of MS can contribute substantially to interindividual differences in treatment outcomes. This review aims to provide an overview of previous studies that have examined genetic polymorphisms associated with the clinical efficacy of natalizumab. A systematic literature search was conducted across the PubMed, Google Scholar, and ResearchGate databases using targeted keywords relevant to the subject matter. Several genetic loci were found to be linked to natalizumab responsiveness, including the integrin subunit alpha 4 (ITGA4
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