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.
E.M. Forster (1879-1970) is one of the important novelists who dealt with the personal and social lives of the people in England during the early beginning of the twentieth century. During his literary career, he developed gradually his views about man and his position in society.
In his first novel, Where Angels Fear to Tread (1902), the focus is laid on local and personal issues in the lives of the characters. It is limited to the relations between neighbours in small communities. Though the setting is shifted to Italy, Forster does not make full use of this shift to present cultural or racial conflicts; rather he limits his plot to the private tr
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Most studies indicated that the values of atmospheric variables have changed from their general rates due to pollution or global warming etc. Hence, the research indicates the changes of direct solar radiation values over a whole century i.e. from 1900 to 2000 depending on registered data for four cities, namely (Mosul - Baghdad - Rutba - Basra. Moreover, attemptsto correlate the direct solar radiation with the temperature values have been recorded over that period. The results showed that there is a decreasing pattern of radiation quantities over time throughout the study period, where the value of direct radiation over the city of Baghdad 5550 w/m2 was recorded in the year 1900, but this ratio decreased cle
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As performers in a social world, we communicate with other people by sharing information on many different levels. Each utterance includes linguistic information and conveys much information about the speaker’s identity. Variation in voice quality indexes information about the speaker and marks the speaker’s identity as a unique individual. The present study aims to validate the belief that each individual has an inalienable voice print that can’t be imitated. The study verifies that, even the more similar personality between two individuals, or the close position in society the variance is voice quality. The acoustic analysis is performed via analysing the acoustic parameters namely: the fundamental frequency, amplitude, inten
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Introduction The Hybrid Gamma Camera (HGC) is being developed to enhance the localisation of radiopharmaceutical uptake in targeted tissues during surgical procedures such as sentinel lymph node (SLN) biopsy. Purpose To assess the capability of the HGC, a lymph-node-contrast (LNC) phantom was constructed for an evaluative study simulating medical scenarios of varying radioactivity concentration and SLN size. Materials and methods The phantom was constructed using two methyl methacrylate PMMA plates (8 mm thick). The SLNs were simulated by drilling circular wells of diameters ranging between 10 mm and 2.5 mm (16 wells in total) in one plate. These simulated SLNs were placed underneath scattering material with thicknesses ranging between 5 mm
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The present study deals with the effect of teaching speaking Strategies (SS) on EFL Iraqi College students. The use of speaking strategies not only solves learners’ communication problems, but also enhances the learner’s interaction in target language, and improves their oral proficiency .The aim of the study is to find out the effect of teaching SS used by EFL College students .The learner of the first stage is population of the study at the Department of English, College of Education /Ibn-Rushd .The sample consists of (60) students distributed on experimental group(A) as well as control group(B) each group contains (30) students . In order to achieve the aim of the study, questionnaire has been constructed to be taught on the experime
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In this work, two algorithms of Metaheuristic algorithms were hybridized. The first is Invasive Weed Optimization algorithm (IWO) it is a numerical stochastic optimization algorithm and the second is Whale Optimization Algorithm (WOA) it is an algorithm based on the intelligence of swarms and community intelligence. Invasive Weed Optimization Algorithm (IWO) is an algorithm inspired by nature and specifically from the colonizing weeds behavior of weeds, first proposed in 2006 by Mehrabian and Lucas. Due to their strength and adaptability, weeds pose a serious threat to cultivated plants, making them a threat to the cultivation process. The behavior of these weeds has been simulated and used in Invas
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Abstract Background: Kaposi’s sarcoma (KS) is an angioproliferative neoplastic disorder that occurs in different epidemiological forms. Human Herpesvirus type 8 (HHV-8) is established as a causative agent of KS that has been mentioned in textbooks and literature. In the last two decades, KS cases were up searched through many Iraqi medical researches which have been published, but unfortunately, none of which had confirmed this association. Objectives: To assess the association of latent nuclear antigen-1(LANA-1) of HHV-8 among KS patients with clinicopathological parameters and to evaluate if this procedure is valuable for diagnosing this disease through the first immunohistochemical study in Iraq. Methods: This is a clinico-immunohis
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