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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In this work, the spirurid nematode Hartertia gallinarum was reported in the intestine of the spotted sandgrouse, Pterocles senegallus, collected in three different locations: Ga'ara Depression, Iraqi Western Desert, Zurbatiyah and Al-Attariyah, Middle of Iraq. Description and measurements of the nematode were given. The role of termites in the infection of P. senegallus with H. gallinarum was discussed. Occurrence of H. gallinarum in P. senegallus represents a new host record.
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The speech delivered by political blocs and parties and broadcasted by satellite channels, social and communication media has different ideologies and orientations: moderate speech calling for calm or one raising crises.The latter is considered very challenging due to its local and international reference., this paper aims at uncovering these challenges especially during the political crisis witnessed in Iraq. This paper sheds light on the most important crisis that spread in public opinion, broadcasted by satellite, and raised by politicians who are competing to gain authority leading to a lack of peoples, confidence in them.This matter should not be neglected at all; e |
Diabetes mellitus is a chronic illness that commonly leads to progressive and incapacitating of patients’ condition over the past 20 years.
The aim of the study was to evaluate the effects of the coughing technique, ShotBlockerTo evaluate the effects of the coughing technique, ShotBlocker and vibration device on pain intensity and patient satisfaction during subcutaneous (SC) insulin injections in hospitalised adults with Type 2 diabetes mellitus (T2DM).
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Land Use / Land Cover (LULC) classification is considered one of the basic tasks that decision makers and map makers rely on to evaluate the infrastructure, using different types of satellite data, despite the large spectral difference or overlap in the spectra in the same land cover in addition to the problem of aberration and the degree of inclination of the images that may be negatively affect rating performance. The main objective of this study is to develop a working method for classifying the land cover using high-resolution satellite images using object based method. Maximum likelihood pixel based supervised as well as object approaches were examined on QuickBird satellite image in Karbala, Iraq. This study illustrated that
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Inherent fluctuations in the availability of energy from renewables, particularly solar, remain a substantial impediment to their widespread deployment worldwide. Employing phase-change materials (PCMs) as media, saving energy for later consumption, offers a promising solution for overcoming the problem. However, the heat conductivities of most PCMs are limited, which severely limits the energy storage potential of these materials. This study suggests employing circular fins with staggered distribution to achieve improved thermal response rates of PCM in a vertical triple-tube heat exchanger involving two opposite flow streams of the heat-transfer fluid (HTF). Since heat diffusion is not the same at various portions of the PCM unit,
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BACKGROUNDS Nasoalveolar molding (NAM) application is among presurgical management (PSM) techniques used for infants with cleft lip and palate (CLP). It helps to approximate the palatal cleft and to reshape the nasoalveolar complex prior to primary lip repair. This study aimed to explore types of PSM and the dental speciality provision for infants with CLP in Baghdad. The status of NAM usage and surgeons’ perceptions toward NAM usage were assessed. MATERIALS AND METHODS This is a cross-sectional paper-based questionnaire study that collected responses of surgeons perform primary lip and nose repair regarding PSM. The questionnaire was distributed amongst public and private hospitals in Baghdad. Twenty surgeons were enrolled (only those su
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