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.
In this study, poly4-(nicotinamido)-4-oxo-2-butenoic acid (PNOE) was prepared by the electro polymerization of 4-(nicotinamido)-4-oxo-2-butenoic acid (NOE) monomer on a 316 stainless steel (St.St) which acts as an anticorrosion coating. Fourier transforms infrared (FTIR), atomic force microscopy (AFM), scanning electron microscopy (SEM), and cyclic voltammetry were used to diagnose the structure and the properties of the prepared polymer layer. The corrosion behavior of the uncoated and coated 316 St.St were evaluated by using an electro chemical polarization technique in 0.2 M hydrochloric acid solution as a corrosive medium at a temperature range of 293 to 323 K. Nano materials, such as nano ZnO and graphene were added in di
... Show MoreThis research aims to examine the effectiveness of a teaching strategy based on the cognitive model of Daniel in the development of achievement and the motivation of learning the school mathematics among the third intermediate grade students in the light of their study of "Systems of Linear Equations”. The research was conducted in the first semester (1439/1440AH), at Saeed Ibn Almosaieb Intermediate School, in Arar, Saudi Arabia. A quasi-experimental design has been used. In addition, a (pre & post) achievement test (20 Questions) and a (pre & post) scale of learning motivation to the school mathematics (25 Items) have been applied on two groups: a control group (31Students), and an experimental group (29 Students). The resear
... Show MoreObjectives: To evaluate the effect of non-pharmacological pain relief methods on duration of labor stage.
Methodology: A quasi-experimental study design was conducted during the period of (4th July 2018 through 24th October 2018) on non-probability of (60) women (30) of them were a control group and (30) were the study group whom admitted to Al-Elwyia Maternity Teaching Hospital suffering from labor pain. A questionnaire was used as a tool of data collection Descriptive& Inferential statistical analyses were used to analyze the data.
Result: The highest percentages of study and control groups were in age group (< 20) years old, primary schools graduates, housewife, from "urban area", within low category of socioeconomic scal
Resumen:
El horóscopo que es una predicción deducida de la posición de los astros del sistema solar y de los signos de Zodiaco, intenta no sólo predecir el futuro, sino también influir en el comportamiento del lector, orientándolo para que actúe adecuadamente y la invitación a actuar ante ese futuro que se aconseja mediante imperativos, perífrasis y otros recursos lingüísticos. Los horóscopos se caracterizan por su gran popularidad que existen en periódico o revista en columnas enteras dedicadas al tema, en donde se detallan la influencia que tendrá el día o el mes de cada uno de los signos correspondientes al zodíaco, siempre teniendo en cuenta la posici
... Show MoreThe limitations of conventional cement mortar as a widely used construction material include low tensile capacity, high permeability, and susceptibility to chemical degradation. The increasing demand for durable and sustainable construction materials has led to increased attention in modifying cementitious materials through nanotechnology. This study investigates the influence of nano-silica (NS) and nano-alumina (NA) on the physical, strength-related, and durability characteristics of cement mortar to determine the optimum nanomaterial type and dosage for performance enhancement. Six mortar mixes, in addition to a reference mix, were designed and prepared by adding 1%, 1.5%, and 2% of the cement weight with NS and NA separately, an
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The research aimed to test the relationship between the size of investment allocations in the agricultural sector in Iraq and their determinants using the Ordinary Least Squares (OLS) method compared to the Error Correction Model (ECM) approach. The time series data for the period from 1990 to 2021 was utilized. The analysis showed that the estimates obtained using the ECM were more accurate and significant than those obtained using the OLS method. Johansen's test indicated the presence of a long-term equilibrium relationship between the size of investment allocations and their determinants. The results of th
... Show MoreThe research aimed to study the job satisfaction of the staff of the Federal board of supreme Audit and its relation to the effectiveness of their performance, The questionnaire was adopted as a main tool in the collection of data and information from a random sample of (54) employees of the Federal board of supreme Audit. In light of this, the data were collected and analyzed and the hypotheses were tested using the statistical program (SPSS).
The researchers reached a number of conclusions, the most important of which were: (1) the respondents' response to the variables of job satisfaction and the effectiveness of the performance were medium; (2) there was a significant relationship between job satisfaction and performance effe
... Show MoreSuzanne Collins’ novel The Hunger Games suggests a new logic of victory and set a distinguished focus on the unique personality of her heroin which brings to the mind the permanent correlation between all moral values. The Hunger Games World seems to be much more like one big bowl as it links the past, present, and the future. An Intertextual reference is interwoven in the present research as it brings Golding’s Lord of the Flies to the surface, and it highlights certain similarities between the two texts. In which Ralph, Piggy and Simon in Golding’s Lord of the Flies are the incarnations of stable moral values and hope of surviving ethics and rules in a chaotic and turmoil world. The event
... Show MoreAntibiotic resistance has been a growing worldwide public health issue. The World Health Organization (WHO) has stated that the search for new antibiotics is slow, while antibiotic resistance is growing. WHO has also declared that antibiotic resistance is one of the top 10 global public health threats facing humanity in the 21st century. Therefore, this review discusses the potential of metal-based drugs as antibacterial agents from the period of the early 2000s to date. The review reveals that a lot of preliminary work has been done to assess these as potential drugs. However, their mode of action is faintly described. Furthermore, a few examples of metal-based drugs assessed for their modes of action are described. These compounds are ide
... Show MoreThis study aims to identify the role of forensic accounting in the Iraqi environment, banking stability, and to achieve this goal, we used the field survey method, as it is the most appropriate for studying the phenomenon in question and achieving its objectives.
Where we selected a sample consisting of (50) male and female employees, distributed among five private banks in Baghdad governorate, namely (Ashur International Bank, Development Investment Bank, Iraqi Middle East Investment Bank, Hammurabi Commercial Bank, Khaleej Commercial Bank), and the questionnaire tool was applied to them Designed for this purpose, which consisted of
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