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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The researcher shed light on a diet in Iraq before 2003 became in this period. And how the ration card has a variety of vocabulary and cover the need of the population of commodities and have a key role in saving Iraq from a real crisis in the period of economic siege, especially in light of the State's direction to support the agricultural sector, which in that period able to fill half of the market needs of food the basic. As well as providing strategic storage at the Ministry of Commerce enough for six months But after the events of 2003 and the crises that hit the country and the unstable security situation began to rise voices calling for reform of the ration card system as a system that is a burden on the
... Show MoreThis paper provides an identification key to the species of Orthetrum Newman, 1833 (Odonata, Libellulidae), including six species that were collected from different localities in Iraq.
The species of O. anceps (Schneider, 1845) is registered as a new record in Iraq; the most important characters which are used in diagnostic key are included
Objective: The approximate life span of a silicone maxillofacial prosthesis is as short as1.5–2 years of clinical service, then a new prosthesis should be fabricated. The most common reasonfor re-making the prosthesis is silicone mechanical properties degradation. The aim of this studywas to assess some mechanical properties of VST-30 silicone for maxillofacial prostheses after addi-tion of intrinsic pigments.Methods: Two types of intrinsic pigments (rayon flocking and burnt sienna); each of them wasincorporated into silicone. One hundred and twenty samples were prepared and split into 4 groupsaccording to the conducted tests (tear strength, hardness, surface roughness, and tensile strengthand elongation percentage) with 30 samples for ea
... Show MoreCommunity detection is useful for better understanding the structure of complex networks. It aids in the extraction of the required information from such networks and has a vital role in different fields that range from healthcare to regional geography, economics, human interactions, and mobility. The method for detecting the structure of communities involves the partitioning of complex networks into groups of nodes, with extensive connections within community and sparse connections with other communities. In the literature, two main measures, namely the Modularity (Q) and Normalized Mutual Information (NMI) have been used for evaluating the validation and quality of the detected community structures. Although many optimization algo
... Show MoreModern American elegy reveals a change in the attitude of mourning from the traditional lamenting approach to some antielegiac attitudes towards the mourned figure. Many American poets have lamented the pass away of the stately figure of the father. However, some poets attack their dead father, and ridiculed him in a poem that is intended to be an elegy, instead of showing passion, homage and love to him. In this regard, two poetic attitudes to the father can be traced in modern American poetry. The first one takes the form of tributes and praise, offering great admiration, compassion, and love for the father. For these poets, a father is an inspiration. The second voice develops some anger and contempt against the patriarchal authority emb
... Show MoreGas lift is one of the most important artificial lift methods for increasing oil production, as wells often require this method after the reservoir's energy has decreased. In this research, an optimal gas lift system is designed for five horizontal wells in the Ahdab oil field, which suffers from low production. At the same time, water cut in some of these wells reaches 66%, while the productivity index is low in others, which makes the challenges clear, and a deep analysis is needed to find an optimal system. The Pipesim program is used to design the optimal gas lift system, which contains features that facilitate the implementation of the appropriate design and provide the ability to analyze and determine the optimal design v
... Show MoreThis research aims to knowledge the extent of the application of Tuz General Hospital to the concept of tacit knowledge dimensions (mental models, intuition, experience, skill) and methods of acquiring knowledge dimensions (training, job rotation, work teams) and the measurement and analysis of the link and the kind of impact between the methods of acquiring knowledge and tacit knowledge of the Angels nursing in the researched hospital, and was the questionnaire primary means of collecting information adopted by the researcher that, the research sample of (90) individuals, including the Angels nursing, has been using the statistical program spss for the purpose of conducting statistical treatments, and through the diagnosis and m
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The research stems from the problem that focuses on a number of questions. They are as follows: What is the extent of interest in the topic of efficiency by the banks and their role in raising the efficiency of the banking business and its development? Is the banking efficiency used in Iraqi banks clear and specific for the Iraqi banking sector? How the banking sector efficiency is measured and what are the approaches adopted in determining the banking inputs and outputs? What is the level of efficiency in the research sample of the banks and what are the causes of its decline or rise in private banks individually and in the Iraqi banking sector in general?
The re
... Show MoreThe study aims to select suitable ornamental plant species that can survive relatively with high concentrations of acetaminophen and methylparaben in constructed wetlands. Alternanthera spp, Asparagus aethiopicus and Chlorophytum comosum are examined to withstand three initial concentrations, 20, 100 and 200 mg/L of acetaminophen and methylparaben. A total of 21 plastic pails with each 3 L capacity consisting of nine pails are used for each pharmaceutical and personal care products (PPCPs) compounds (acetaminophen and methylparaben) for three ornamental plants (Alternanthera spp, Asparagus aethiopicus and Chlorophytum comosum), with three pails as plant controls. The results reveales
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