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 presence of deposition in the river decreases the river flow capability's efficiency due to the absence of maintenance along the river. In This research, a new formula to evaluate the sediment capacity in the upstream part of Al-Gharraf River will be developed. The current study reach lies in Wasit province with a distance equal to 58 km. The selected reach of the river was divided into thirteen stations. At each station, the suspended load and the bedload were collected from the river during a sampling period extended from February 2019 till July 2019. The samples were examined in the laboratory with a different set of sample tests. The formula was developed using data of ten stations, and the other three s
... Show MoreThe purpose of this paper is to gain a good understanding about wake region behind the car body due to the aerodynamic effect when the air flows over the road vehicle during its movement. The main goal of this study is to discuss the effect of the geometry on the wake region and the aerodynamic drag coefficient. Results will be achieved by using two different shapes, which are the fastback and the notchback. The study will be implemented by the Computational Fluid Dynamic (CFD) by using STAR-CCM+® software for the simulation. This study investigates the steady turbulent flow using k-epsilon turbulence model. The results obtained from the simulation show that the region of the air separation behind the vehicle
... Show MoreMultilateral wells require a sophisticated type of well model to be applied in reservoir simulators to represent them. The model must be able to determine the flow rate of each fluid and the pressure throughout the well. The production rate calculations are very important because they give an indication about some main issues associated with multi-lateral wells such as one branch may produce water or gas before others, no production rate from one branch, and selecting the best location of a new branch for development process easily.  
... Show MoreBackground : Shoulder pain is a common problem that can pose difficult diagnostic and therapeutic challenges for the family physician It is the third most common musculoskeletal complaint in the general population, and account for 5% of all general practitioners musculoskeletal consults
Objective: To determine the diagnostic performance of ultrasonography compared with the physical examination for detection of rotator cuff tears in painful shoulder syndrome.
Method: Prospective study was done on seventy patients (48 male, 22 female), age ranged between 30-70 years (mean age 50 years), From February 2007 to July 2011, were subjected to comparative study in Al-Kindy teaching hospital with rotator cuff tears, including physical and ul
Psychological aspects are a major influence and motivation factor in many cinematic and television works such as television series. There are many films that dealt with psychological issues through the personality affected by psychological projections and complexes that lead towards abnormal behavior and actions in most cases, so the researchers chose the title and the research problem was raised through the following question: What is the mechanism that fulfills a psychological role in the narrative film? The objectives of the research were to reveal the mechanism used to instill psychological contents in the feature film? As for the limits of the research, it was an intentional sample, and the researchers adopted the descriptive anal
... Show MoreThe current study aimed to ascertain the levels of matrix metalloproteinase-12 (MMP-12) and Lysyl oxidase (LOX) in osteoporosis patients and their correlation with alkaline phosphatase (ALP), magnesium (Mg), vitamin D (Vit D), calcium (Ca), phosphorus (P), and T-score %. 110 participants recruited from Baghdad Teaching Hospital, Iraq, were enrolled in this study from November 2019 to March 2020). The participants were divided into two groups: Group 1 comprised 60 osteoporotic women and group 2 consisted of 50 healthy women. (MMP and LOX) were estimated using a quantitative enzyme-linked immunosorbent assay (ELISA. The results showed significant differences in serum LOX, age, ALP, Mg, and T-score %, while no significant differences i
... Show MoreConcrete columns with hollow-core sections find widespread application owing to their excellent structural efficiency and efficient material utilization. However, corrosion poses a challenge in concrete buildings with steel reinforcement. This paper explores the possibility of using glass fiber-reinforced polymer (GFRP) reinforcement as a non-corrosive and economically viable substitute for steel reinforcement in short square hollow concrete columns. Twelve hollow short columns were meticulously prepared in the laboratory experiments and subjected to pure axial compressive loads until failure. All columns featured a hollow square section with exterior dimensions of (180 × 180) mm and 900 mm height. The columns were categorized into
... Show MoreAbstract- Asymptomatic or clinically silent kidney stones are possibly serious because, in their expected passage, they may cause infection, obstruction and renal impairment. The purpose of this study was to determine the prevalence of silent kidney stones in a sample of Baghdad population and consider how this value could affect the justification for a screening system. To our best knowledge, this is the first study of its kind conducted in Iraq. We investigated 714 consecutive patients who sustained an abdominal ultrasound at our hospital with further kidney screening. All these patients did not have clinical signs and symptoms of nephrolithiasis. Age, sex, the indication for ultrasound, the size, side, and the number of the disco
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