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.
Some new norms need to be adapted due to COVID-19 pandemic period where people need to wear masks, wash their hands frequently, maintain social distancing, and avoid going out unless necessary. Therefore, educational institutions were closed to minimize the spread of COVID-19. As a result of this, online education was adapted to substitute face-to-face learning. Therefore, this study aimed to assess the Malaysian university students’ adaptation to the new norms, knowledge and practices toward COVID-19, besides, their attitudes toward online learning. A convenient sampling technique was used to recruit 500 Malaysian university students from January to February 2021 through social media. For data collection, all students
... Show MoreObjectivity is the common denominator between the qualities and elements of a news story that is described as the mother of journalistic arts. When there is doubt about the authenticity of the information contained in the press, whether readable, audible or visual, it means that there is an imbalance in objectivity. When, furthermore, there is an incorrect and intentional use of words in order to influence readers, it means to move away from objectivity as a necessary element in the success of the media institution; and the success of its editorial material.
But the objective interpretation may take several dimensions to the liaison. For the purpose of grasping the interpretation of objectivity among those liaisons working in the
... Show MoreThis work is the first study of the Curculionoidea fauna from Kurdistan region of Iraq, based on the intensive survey in different localities of Kurdistan from March 2016 to November 2017. In total, 41 species belonging to 28 genera, 21 tribes and 3 families were collected and identified, including 25 species newly recorded for the Iraqi fauna.
General distribution, collecting localities and methods, with plant association data for each species are given.
The current research aims to build a training program for chemistry teachers based on the knowledge economy and its impact on the productive thinking of their students. To achieve the objectives of the research, the following hypothesis was formulated:
There is no statistically significant difference at (0.05) level of significance between the average grades of the students participating in the training program according to the knowledge economy and the average grades of the students who did not participate in the training program in the test of productive thinking. The study sample consisted of (288) second intermediate grade students divided into (152) for the control group
... Show MoreOil recovery could be impacted by the relation between vertical permeability (Kv) and horizontal permeability (Kh) (Kv/Kh). 4816 plugs that have been getting hold of 18 wells of Mishrif formation in the West Qurna oilfield were used. Kv/Kh data provided some scatter, but the mean is ~1. Kv/Kh =1 was used for the Petrel model before upscaling according to the heterogeneity of each layer.
Kv/Kh values for Mishrif Formation in West Qurna Oilfield are 0.8 for relatively homogeneous, 0.4 for heterogeneous rock, and 0.1 for cap rocks (CRII).
Eclipse TM was used for reservoir simulation. PVT and SCAL data e
... Show MoreWhatever the designers of the advertisement in choosing the text and spoken phrases, those phrases cannot give or convey the full meaning to the recipient only if this spoken and written language is reinforced with another language based on the signals, movements, and symbols that are displayed using the body or other artistic elements of the advertisement such as pictures, colors, music, effects, and other elements used in the artistic construction of television advertising. All these artistic elements contribute to the completion of the advertising idea and make it ready to be displayed to the public.
Scientists and researchers, in the field of psychology, have relied a lot on this language (body language). And some of them put
... Show MoreRandom laser gain media is synthesized with different types of dye at the same concentration (1×10-3 M) as an active material and silicon dioxide NPs (silica SiO2) as scatter centers through the Sol-Gel technique. The prepared samples are tested with UV–Vis spectroscopy, Fluorescence Spectroscopy, Field Emission Scanning Electron Microscopy (FESEM), and Energy Dispersive X-ray Diffraction (EDX). The end result demonstrates that doped dyes with silica nanoparticles at a concentration of 0.0016 mol/ml have lower absorbance and higher fluorescence spectra than pure dyes. FESEM scans revealed that the morphology of nanocrystalline silica is clusters of nano-sized spherical particles in the range (25-67) nm. It is con
... Show MoreTo evaluate the cost-effectiveness of emicizumab compared to recombinant activated factor VII (rFVIIa) in Iraqi patients with hemophilia A and inhibitors.
A retrospective cost-effectiveness analysis was conducted on 46 male patients with hemophilia A and inhibitors treated at a public children’s hospital in Baghdad. Data collection was conducted between November 2024 and March 2025. Clinical and economic data were retrospectively collected for a 12-m
This study examines the vibrations produced by hydropower operations to improve embankment dam safety. This study consists of two parts: In the first part, ANSYS-CFX was used to generate a three-dimensional (3-D) finite volume (FV) model to simulate a vertical Francis turbine unit in the Mosul hydropower plant. The pressure pattern result of the turbine model was transformed into the dam body to show how the turbine unit's operation affects the dam's stability. The upstream reservoir conditions, various flow rates, and fully open inlet gates were considered. In the second part of this study, a 3-D FE Mosul dam model was simulated using an ANSYS program. The operational turbine model's water pressure pattern is conveyed t
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