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.
Atheists have spread in the modern era, so that atheism has become a bad phenomenon in the world in general and in Islamic societies in particular, so the research aims to study the individual and social effects left by atheism on the atheists themselves, and the research included multiple axes: atheism linguistically and idiomatically, atheism in the Qur’an Noble and Modern (and Contemporary) Atheism Statistics: and the reasons for atheism: Studying the phenomenon of atheism in Iraq as a model, then studying the effects of atheism: on the individual first, then atheism and its impact on society, then the conclusion, recommendations, sources and references
Afamin, which is a human plasma glycoprotein, a putative multifunctional transporter of hydrophobic molecules and a marker for metabolic syndrome. Afamin concentration have been proposed to have a significant role as a predictor of metabolic disorders. Since NAFLD is associated with metabolic risk factors, e.g., dyslipidemia, insulin resistance and visceral obesity, it is considered as the hepatic manifestation of the metabolic syndrome. The objective of this study is to determine Afamin levels in hypothyroid patients with and without fatty liver disease and compare the results with controls. Also to study the relationship of Afamin level with the Anthropometric and Clinical Features (Age, Gender, BMI and Duration of Hypothyroidism) , Serum
... Show MoreIn this paper, we will study non parametric model when the response variable have missing data (non response) in observations it under missing mechanisms MCAR, then we suggest Kernel-Based Non-Parametric Single-Imputation instead of missing value and compare it with Nearest Neighbor Imputation by using the simulation about some difference models and with difference cases as the sample size, variance and rate of missing data.
Due to increased consumption of resources, especially energy it was necessary to find alternatives characterized by the same quality as well as being of less expensive, and most important of these alternatives are characterized by waste and the fact that humancannot stop consumption. So we have consideredwaste as an alternative and cheap economic resources and by using environmental index the MIP (input materials per unit ,unit / service) is based on the grounds that the product is not the end of itselfit is a product to meet the need of a product or service, awarded a resource input and output within the five basic elements are the raw materials is ecological, Raw materials ecological, water, air and soil erosion for a
... Show MoreInterface bonding between asphalt layers has been a topic of international investigation over the last thirty years. In this condition, a number of researchers have made their own techniques and used them to examine the characteristics of pavement interfaces. It is obvious that test findings won't always be comparable to the lack of a globally standard methodology for interface bonding. Also, several kinds of research have shown that factors like temperature, loading conditions, materials, and others have an impact on surface qualities. This study aims to solve this problem by thoroughly investigating interface bond testing that might serve as a basis for a uniform strategy. First, a general explanation of how the bonding strength
... Show MoreInterface bonding between asphalt layers has been a topic of international investigation over the last thirty years. In this condition, a number of researchers have made their own techniques and used them to examine the characteristics of pavement interfaces. It is obvious that test findings won't always be comparable to the lack of a globally standard methodology for interface bonding. Also, several kinds of research have shown that factors like temperature, loading conditions, materials, and others have an impact on surface qualities. This study aims to solve this problem by thoroughly investigating interface bond testing that might serve as a basis for a uniform strategy. First, a general explanation of how
... Show MoreDust and bird residue are problems impeding the operation of solar street lighting systems, especially in semi-desert areas, such as Iraq. The system in this paper was designed and developed locally using simple and inexpensive materials. The system runs automatically. It Connects to solar panels used in solar street lighting, and gets the required electricity from the same solar system. Solar panels are washed with dripping water in less than half a minute by this system. The cleaning period can also be controlled. It can also control, sensing the amount of dust the system operates. The impact of different types of falling dust on panels has also been studied. This was collected from different winds and studied their impact o
... Show MoreDialogue is one of the most important means of calling to the Creator, as it is one of the scientific and verbal activities carried out by a group of interlocutors to present ideas they believe in, and evidence and proofs that express their views and demonstrate the reason for their belief in them, In order to arrive at the truth or a radical solution to a specific problem, so the interlocutor should pay attention to this science, study it and its etiquette, because the purposeful dialogue requires that the funniest of them be the most knowledgeable and knowledgeable about the axis of the hadith, and the funniest must also be able to be convinced of the rule of difference of opinion that does not spoil the issue of friendly They must also c
... Show MoreIn this study a new antiseptic was formulated and tested to match the effectiveness against microorganisms. The formulation consisted of Povidone - Iodine (PVP-I) (10%), H2O2 (3%) and Aloe Vera gel (pure). Different ratios of these materials were prepared within the acceptable range of pH for an antiseptic (3-6). The prepared samples were tested. The In Vitro test was performed by using four bacteria, two were Gram-Positive (Staphylococcus aureus and Bacillus cereus) and two were Gram-Negative (Escherichia coli and Pseudomonas aeruginosa). The new antiseptic showed 100% killing rate for E. coli, Ps. aeruginosa and S. aureus and 96.4667% killing rate for B. cereus. When the new antiseptic was compared with two common
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