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.
Urban expansion and its environmental and safety effects are one of the critical information needed for future development planning, safety considerations and environmental management. This work used two methods to monitor urban expansion and it's environmental and safety effects, the first is based on Google Maps for the years 2002 and 2010, and the second was the usage of spatial videos for the year 2013. Although the usage of satellite images is critical to know and investigate the general situation and the total effects of the expansion on a large piece of area, but the Spatial videos do a very detailed fine scale investigation, site conditions regarding both environmental and safety cannot be easily distinguished fr
... Show MoreThis study aims to measure and analyze the direct and indirect effects of the financial variables, namely (public spending, public revenues, internal debt, and external debt), on the non-oil productive sectors with and without bank credit as an intermediate variable, using quarterly data for the period (2004Q1–2021Q4), converted using Eviews 12. To measure the objective of the study, the path analysis method was used using IBM SPSS-AMOS. The study concluded that the direct and indirect effects of financial variables have a weak role in directing bank credit towards the productive sectors in Iraq, which amounted to (0.18), as a result of market risks or unstable expectations in the economy. In addition to the weak credit ratings of borr
... Show MoreIn this paper, the system of the power plant has been investigated as a special type of industrial systems, which has a significant role in improving societies since the electrical energy has entered all kinds of industries, and it is considered as the artery of modern life.
The aim of this research is to construct a programming system, which could be used to identify the most important failure modes that are occur in a steam type of power plants. Also the effects and reasons of each failure mode could be analyzed through the usage of this programming system reaching to the basic events (main reasons) that causing each failure mode. The construction of this system for FMEA is dependi
... Show MoreThe negotiation phase is gaining great importance in investment loans due to the magnitude of the amounts awarded and the need to obtain adequate lending guarantees and the development of better conditions, and this requires that negotiating policy with fixed principles that balance between meeting the demands of customers and maintain market share and achieve profits and avoid defaults and losses the bank, and so I have touched Find the concept of investment loans and procedures for granting and the concept of the negotiation process for the granting of loans. The practical side to ensure the preparation of examination form consists of questions commensurate with the methodology developed by the researchers, were directed to the officia
... Show MoreThis study was conducted in Diyala province for renal failure patients during the periods August 2015 - April 2016. Hundred renal failure patients were enrolled in the study after diagnosis by the consultant physician at Ibn-Sina Center for Dialysis in Baquba Teaching Hospital according to criteria adopted by the World Health Organization for diagnosis of renal failure disease. The number of males in patient’s sample was 61 (61%) and females was 39 (39%) with an age range of 10 – 88 year (44.7 ± 22.1 year). In addition, the study included 50 apparently healthy individuals and considered as a group control, in which the number of males and females was similar (25 individual), with an age range of 18 – 88 year (51.7 ± 17.3 year). The
... Show MoreBackground: The ideal maxillofacial prosthesis should have fine and thin boundaries that bindwith the surrounding facial structures and possess high tear strength.This study aims to determinethe best percentages of nanofiller (TiO2) and intrinsic pigment (silicone functional intrinsic) thatcould be mixed in as additives to improve the tear strength of Cosmesil M511 andVST50F siliconeelastomers with the least effect on their hardness.Materials and Methods: In this in vitro experimental study, a total of 80 samples, 40 for eachelastomer, were fabricated. Each elastomer sample was split into two equal groups to test for tearstrength and Shore A hardness. Each group consisted of 20 samples, including 10 control sampleswithout additives and 10 e
... Show MoreThe research deals with the interchange of the sign transformed from the universal to the local in the theatrical show through the direction processing in the production of a communicative artistic discourse and message, thus making the process of reading the speech and recognizing it by taking into account the cultural differences, customs and local rituals of each country, region, or area. The problem of the research was focused on answering the following question: What are the requirements for the sign in terms of its transformation between the universality and locality in the read-out?
The importance of research is to determine the requiremen
... Show MoreObjectives: The research aims to highlight the semiotic approach and apply it to a photograph of the Pope's reception at Baghdad International Airport, published on the page of the Media Office of Iraqi Prime Minister Mustafa Al-Kazemi in the Twitter application, in order to study its components, analyze its contents and clarify its implications, as well as approach the image as a political and media act. Methods: The stages of research were accomplished by "investigation, observation, and analysis", and the dismantling of the composition of the photograph, thus revealing the hidden and hidden aspects, relying on the semiotic approach to analysis. Results: The study showed that the ideas and meanings included in the image in form
... Show MoreThrough the early childhood and after the ablactating the child learns acquired food habbits that might studying with him throughout his life. Here the parents role arises: teaching the child the sound food habits and hygienic styles and whatever beneficial to the health and with the sufficient quantities for the body. In this way the experiences the child learns at home will be of great help in his future life in choosing the suitable food after becoming more dependent in making his decisions and choices away from his parents. The results in this study showed that the averages of the children’s consumption of the high energy foods in comparison with the other highest consumption average , after that comes the con sumption of soft drills
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