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.
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Many economists believe that the development and promotion of small and medium-sized enterprises is one of the most important sources of economic and social development in countries in general and in developing countries in particular. This is considered to be an essential starting point for increasing production capacity and contributing to tackling poverty and unemployment. In view of the importance of these projects, most developing countries have concentrated their efforts on them. They have encouraged the establishment of small and medium industries, especially after they have proved their ability and efficiency in dealing with the major problems facing different economies.
The banking system plays an important role by finan
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The involvement of maxillofacial tissues in SARS‐CoV‐2 infections ranges from mild dysgeusia to life‐threatening tissue necrosis, as seen in SARS‐CoV‐2‐associated mucormycosis. Angiotensin‐converting enzyme 2 (ACE2) which functions as a receptor for SARS‐CoV‐2 was reported in the epithelial surfaces of the oral and nasal cavities; however, a complete understanding of the expression patterns in deep oral and maxillofacial tissues is still lacking.
The immunohistochemical expression of ACE2 was analyzed in 95 specimens from maxillofacial tissues and 10 specimens o
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رافقت القسوة الانسان منذ القدم وكثيرا ما تم الخلط بينها وبين العنف لشدة التقارب بينهما , وهنا يحاول البحث ان يفصل بين كلا المفهومين ويتفرد بمفهوم القسوة, الذي سلط عليه الضوء في المسرح لأول مرة على يد الفرنسي(انطوان ارتو) في محاولة للكشف عن المعالجة الاخراجية التي قدمها المخرج العراقي(صميم حسب الله) لمفهوم القسوة في مسرحيته الموسومة (خريف) ويتضمن البحث نبذه (مفهوم القسوة في الفكر الانساني) وكذلك (الق
... Show MoreStatistical methods of forecasting have applied with the intention of constructing a model to predict the number of the old aged people in retirement homes in Iraq. They were based on the monthly data of old aged people in Baghdad and the governorates except for the Kurdistan region from 2016 to 2019. Using BoxJenkins methodology, the stationarity of the series was examined. The appropriate model order was determined, the parameters were estimated, the significance was tested, adequacy of the model was checked, and then the best model of prediction was used. The best model for forecasting according to criteria of (Normalized BIC, MAPE, RMSE) is ARIMA (0, 1, 2)
The paper deals with the study of the sciences of the Qur’an according to the interpreter, Ayatollah Sayyid Mahmoud al-Talaqani, a religious jihadist figure from Iran. He is the author of the exegesis (Ishraq from Al-Quran), which consists of six parts, which he wrote inside the prisons of the Shah and in exile. Mr. Al-Talaqani agreed with some of the commentators in his positions on the sciences of the Qur’an, and some of them disagreed with others.
The potential application of granules of brick waste (GBW) as a low-cost sorbent for removal of Ni+2ions from aqueous solutions has been studied. The properties of GBW were determined through several tests such as X-Ray diffraction (XRD), Energy dispersive X-ray (EDX), Scanning electron microscopy (SEM), and BET surface area. In batch tests, the influence of several operating parameters including contact time, initial concentration, agitation speed, and the dose of GBW was investigated. The best values of these parameters that provided maximum removal efficiency of nickel (39.4%) were 1.5 hr, 50 mg/L, 250 rpm, and 1.8 g/100mL, respectively. The adsorption data obtained by batch experiments subjected to the Three i
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Background: The most crucial mechanism of genetic variation in N. meningitidis is the slipped strand mispairing, this mechanism generates Phase variation using simple sequence repeat (SSR) and is commonly used by the N. meningitidis to escape the immune system despite its function in eradicating the pathogenic and commensal bacteria. Some of simple sequence repeats (SSRs) that located within the genome works as phase variation while other SSRs have no role in generating phase variation mechanisms. Therefore, Aim: the main goal of the current in silico study was to detect the probability of SSR to enroll with phase variation for the entire N. meningitidis genome. Methods: Different criteria were used to judge SSR as
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