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.
Background: Stroke defined by diminished cerebral blood flow, results in brain damage and neurological impairments. It often leads to considerable difficulties, such as limited mobility and compromised hand function, usually manifesting as a weakening in the ability to open and shut the hand. Objective: The study evaluates the differences between opening and closing hands when utilizing a soft robot. Methods: The study was conducted in the Mosul Specialist Rehabilitation Center which involved 68 participants, all over 20 years old, with visual impairments. The Iranian Clinical Trials Registry and Ministry of Planning approved the study, The Fugl-Meyer Assessment for Upper Extremity Action Research Arm Test, and Arm Motor Ability Test were
... Show MoreBackground: Diabetic mellitus (DM) is a collection of metabolic disorder identified by hyperglycemia. The heterogeneous etiology includes defects either in insulin secretion, or in insulin action, or the both. In addition to the distraction in carbohydrate, fat and protein metabolism. Inflammatory reaction that caused by many pro-inflammatory cytokines play a central role in the pathogenicity of T2DM, these cytokines can enhance insulin resistance which led to impaired glucose homeostasis. Subjects: The study included 75 patients (38 males and 37 females) suffering from T2DM with age mean ± SE 52.30 ± 1.60, and 70 individuals as healthy controls (35 males and 35 females) with age mean ± SE 48.88 ± 0.64. Evaluation of immunological marke
... Show MoreThis investigation integrates experimental and numerical approaches to study a novel solar air heater aimed at achieving an efficient design for a solar collector suitable for drying applications under the meteorological conditions of Iraq. The importance of this investigation stems from the lack of optimal exploitation of solar energy reaching the solar collector, primarily attributable to elevated thermal losses despite numerous designs employed in such solar systems. Consequently, enhancing the thermal performance of solar collectors, particularly those employed in crop drying applications, stands as a crucial focal point for researchers within this domain. Two identical double-pass solar air heaters were designed and constructed for
... Show MoreWithin the framework of big data, energy issues are highly significant. Despite the significance of energy, theoretical studies focusing primarily on the issue of energy within big data analytics in relation to computational intelligent algorithms are scarce. The purpose of this study is to explore the theoretical aspects of energy issues in big data analytics in relation to computational intelligent algorithms since this is critical in exploring the emperica aspects of big data. In this chapter, we present a theoretical study of energy issues related to applications of computational intelligent algorithms in big data analytics. This work highlights that big data analytics using computational intelligent algorithms generates a very high amo
... Show MoreABSTRACT Background: Generally, the facial esthetics depends on the esthetic appearance of the maxillary anterior teeth. The purposes of this study were to analyse the macro-aesthetic appearance of the face and the micro-aesthetic appearance of the maxillary anterior teeth to establish the normative values for class I normal occlusion and to detect possible gender differences. Materials and methods: The sample consisted of 120 Iraqi adults (60 males and 60 females) aged (18-23) years. Each individual was clinically examined, then with cephalostat based head position, extraoral and intraoral photographs were taken for each subject. The facial and dental measurements were measured using AutoCad program 2014. Descriptive statistics was obtaine
... Show MoreThe current research deals with the argument of delusion and interpretation in the direction structure and its reflected impact in the reception activity and the amount of conceptual displacement it is subjected to in an aesthetic approach to abstract conceptual definitions of the reception activity , by the effect of this dialectic in the direction structure, which can be summed up by the following question: (What are the characteristics of the direction structure of the imaginary and what is the argument of interpretation in the theatre reception activity?) in order to stand on the aesthetic framework and conceptual definition of the direction structure in the controversy of interpretation and imagination, and its impact on the concept
... Show MoreThere is no doubt that each of the arts has a material from which the aesthetic achievement is built, so the researcher found that the art of theater, especially the show, whose artistic achievement is based on the body of the actor who emits the formal language (body language), is the focus of interest and active presence, because the body possesses its spiritual qualities that made him and the ability to The formation of things by (his body language), so the researcher studied this theatrical phenomenon and divided it into four chapters. In the first chapter, the research problem included the following question: (Is there a phenomenon of body language in the contemporary theatrical show "Imagine that" as a model) so It is of cognitive
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There is a theoretical controversy in the books of Usul al-Fiqh, in the past and the present, about whether the ruling should be attached to its reason (al-Hikmah), or its apparent and stable cause (al-Illah). Looking at the practical cases of the jurists, we found them sometimes attaching rulings to its reason, and sometimes to its cause, so there is a need to know the factors that affect their choices. By extrapolation, the researcher reached at nine factors that affect referring the ruling to its cause or to its reason in jurisprudential cases.