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 neutrophil/ lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR) have the potential to be inflammatory markers that reflect the activity of many inflammatory diseases. The aim of this study was to evaluate the NLR and PLR as potential markers of disease activity in patients with ankylosing spondylitis.
The study involved 132 patients with ankylosing spondylitis and 81 healthy controls matched in terms of age and gender. Their sociodemographic data, disease activity scores using the Bath Ankylosing
(46)
(39)
Many studies have evaluated the effect of platelet rich plasma (PRP) in the treatment of non-union fractures but few studies have investigated their effect on the union of femoral neck fractures or their functional outcome in young adults. The aim of this study was to evaluate the union time and functional outcome in young adult patients with femoral neck fracture managed by three cannulated screws injected with PRP and those managed by fixation only. This prospective study included 24 patients diagnosed with femoral neck fractures within 24 hours of presentation. Twelve cases in group A were managed by closed reduction and three cannulated screws fixation injected with PRP; twelve patients in group B were managed only by closed reduction a
... Show More
Banks are considered the main basis of financial sector ,so they must be submitted to sound and strict regulatory system and so as to ensure their operations and according to instructions and regulations , in order to maintain the integrity of the banking sector and financial sector in general .One of the importance regulatory tools that are adopted by the Iraqi Central Bank to control over the banks an financial and periodic statements that are provided by the banks in accordance with planned schedules .The financial statements of the banks must reflect clearly and accurately financial situation and the result of their activities during the period in which they represent to achiveing its purposes.So it has the goal of Search is statemen
... Show More
Electronic properties including (bond length, energy gap, HOMO, LUMO and density of state) as well as spectroscopic properties such like infrared, Raman scattering, force constant, reduced mass and longitu- dinal optical mode as a function of frequency are based on size and concentration of the molecular and nanostructures of aluminum nitride ALN, boron nitride BN and AlxB7-XN7 as nanotubes has calculated using Ab –initio approximation method dependent on density functional theory and generalized gradient approximation. The geometrical structure are calculated by using Gauss view 05 as a complementary program. Shows the energy gap of ALN, BN and AlxB7-XN7 as a function of the total number of atoms , start from smallest molecule to reached
... Show More
(2)
(2)
The research aims to determine the role of green human resource management dimensions of (employment Green, training and development, green, performance evaluation Green, compensation and green bonuses) in the performance leadership of the organization dimensions of (advance planning, efficiency, effectiveness, index pioneering, renovation and modernization), Search of paramount importance because it addresses an important and modern issue in performance leadership, namely green management of human resources, aware of the importance of the subject and expected results of the company under study, an analysis of the data obtained through field visits in
... Show More
Malaysia is linked to the countries of the Middle East by a historical relationship identified by a number of factors and determinants that affected the developments of that relationship, especially its relentless endeavor to preserve its Islamic identity with the leadership of the rest of the other ethnicities, in addition to those factors and international determinants that directly affected the typicality of this relationship and perhaps the United States stands At the forefront of who represents this international variable, as it is considered the Middle East region as a core region and within its vital field, and therefore any analog relationship in the field of international relations and one of its parties is the countries of the
... Show More
This paper presents a comparative study of two learning algorithms for the nonlinear PID neural trajectory tracking controller for mobile robot in order to follow a pre-defined path. As simple and fast tuning technique, genetic and particle swarm optimization algorithms are used to tune the nonlinear PID neural controller's parameters to find the best velocities control actions of the right wheel and left wheel for the real mobile robot. Polywog wavelet activation function is used in the structure of the nonlinear PID neural controller. Simulation results (Matlab) and experimental work (LabVIEW) show that the proposed nonlinear PID controller with PSO
learning algorithm is more effective and robust than genetic learning algorithm; thi
(3)
Background: Hyperplastic polyps account for 30–93% of gastric polyps. Recently, there have been studies about the development of dysplasia in this type of polyp. Every cell in the body contains the p53 gene, which has anti-cancer properties. Objective: The sensitivity of immunohistochemical expression of p53 is evaluated among gastric hyperplastic polyps with and without dysplasia and gastric adenomatous polyps to know its usefulness as a diagnostic marker. Methods: A retrospective cross-sectional study was done on fifty formalin-fixed paraffin-embedded blocks of gastric polyps (44 hyperplastic polyps without dysplasia, 3 hyperplastic polyps with dysplasia, and 3 adenomas). Cases were collected from the archives of the pathology d
... Show More
(1)
(1)
This study investigates the phonotactics of English obstruent clusters in the word-final position from a markedness theory perspective among Iraqi EFL College Students whose native language, Arabic, prefers only two-member word-final obstruent cluster as a maximum. The markedness of clusters is measured depending on Iraqi EFL College Students’ utilization of the simplification strategies. This study tries to answer whether or not word-final obstruent clusters are marked or unmarked for Iraqi EFL College Students, and whether or not the markedness of the obstruent cluster increases as to its length. In order to answer these questions, a test has been distributed among 60 Iraqi EFL Fourth-Year College students, Department of English, Colleg
... Show More