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.
Dylan Thomas (1914-1953) is a modern poet belongs to the apocalyptic movement of the 1940's.This movement is influenced by the doctrines and techniques of surrealism.
Poetry for him should not be primarily concerned with man in society, but with the celebration of spiritual truth. It should bring to light the hidden causes, hence his personal interest is to strip darkness and explore the inward motives. To do this he uses a cluster of images: a constant building up and breaking down of images. His poetry depends on the romantic spontaneity, suggestiveness of the Symbolists and the the surrealists' mysterious liberation of the unconsciousness and
... Show MoreTelevision culture has become the most dangerous of our time. It manipulates with minds and hearts together; and forms consciousness. It transforms societies into actual forces rejecting certain principles by guiding the media landscape through visible connotations acceptable to the public; or provokes the citizen against elements that put a burden on the viewer or the public in order to create a positive reaction to the subject of combating terrorism by combining these ads in line with what the public wants of security and tranquility and a decent living after suffering from terrorism in the past years.
Therefore, this research deals with television advertisements as one of the most important fo
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The goal of the research is to develop a sustainable rating system for roadway projects in Iraq for all of the life cycle stages of the projects which are (planning, design, construction and operation and maintenance). This paper investigates the criteria and its weightings of the suggested roadway rating system depending on sustainable planning activities. The methodology started in suggesting a group of sustainable criteria for planning stage and then suggesting weights from (1-5) points for each one of it. After that data were collected by using a closed questionnaire directed to the roadway experts group in order to verify the criteria weightings based on the relative importance of the roadway related impacts
... Show MoreThe tourism industry has become, currently, an art, an industry and a science. It is also one of the components that make up touristic regions. Tourist attractions are no longer the exclusive visits of museums and archeological sites, but also involve other service facilities. It is, therefore, imperative that the authorities should become aware of the degradation of tourist resorts and prevent them from getting worse. Moreover, the authorities should take a set of decisions concerning the protection of the urban aspect with its historical, social, and environmental dimensions, as well as, adapting it to the modern requirements that can bring comfort to the citizens and tourists at physical and psychological levels.
Dylan Thomas (1914-1953) is a modern poet belongs to the apocalyptic movement of the 1940's.This movement is influenced by the doctrines and techniques of surrealism. Poetry for him should not be primarily concerned with man in society, but with the celebration of spiritual truth. It should bring to light the hidden causes, hence his personal interest is to strip darkness and explore the inward motives. To do this he uses a cluster of images: a constant building up and breaking down of images. His poetry depends on the romantic spontaneity, suggestiveness of the Symbolists and the the surrealists' mysterious liberation of the unconsciousness and the emotional involvement in the dynamics of life. In "Light Breaks
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Electrical distribution system loads are permanently not fixed and alter in value and nature with time. Therefore, accurate consumer load data and models are required for performing system planning, system operation, and analysis studies. Moreover, realistic consumer load data are vital for load management, services, and billing purposes. In this work, a realistic aggregate electric load model is developed and proposed for a sample operative substation in Baghdad distribution network. The model involves aggregation of hundreds of thousands of individual components devices such as motors, appliances, and lighting fixtures. Sana’a substation in Al-kadhimiya area supplies mainly residential grade loads. Measurement-based
... Show MoreOne of the most serious health disasters in recent memory is the COVID-19 epidemic. Several restriction rules have been forced to reduce the virus spreading. Masks that are properly fitted can help prevent the virus from spreading from the person wearing the mask to others. Masks alone will not protect against COVID-19; they must be used in conjunction with physical separation and avoidance of direct contact. The fast spread of this disease, as well as the growing usage of prevention methods, underscore the critical need for a shift in biometrics-based authentication schemes. Biometrics systems are affected differently depending on whether are used as one of the preventive techniques based on COVID-19 pandemic rules. This study provides an
... Show MoreUnter dem Titel " Technische Methoden im Fremdsprachunterricht als eine neueste Methode im Fremdsprachlernen, die Spiele als Muster"
versteht man, dass die Forschung sich mit einer neuen Methoden im Fremdsprachunterricht beschäftigt. Von den neuen Methoden im Unterricht sind die Spiele. So man sieht in den letzten Jahren viele Artikel zum Thema Spiele im Fremdsprschunterricht. Davon gehen wir aus, dass die Spiele im Unterricht eine groβe Rolle spielt, denn diese Methode macht Lust, Spaβ im Lernenprozeβ. Die Spiele im Unterricht bezeichnen als ein Mittel, um Unterricht etwas Schönes , Nützliches und Lebendigs zu sein. Die Spiele sind vielfälltig und unterscheidet sich nach den Themen und Materialien. In dieser F
... Show MoreThe research aims to shed light on the role of artificial intelligence in achieving Ambidexterity performance, as banks work to take advantage of modern technologies, artificial intelligence is an innovation that is expected to have a long-term impact, as well as banks can improve the quality of their services and analyze data to ensure that customers' future needs are understood. . The Bank of Baghdad and the Middle East Bank were chosen as a community for the study because they had a role in the economic development of the country as well as their active role in the banking market. A sample of department managers was highlighted in collecting data and extracting results based on the checklist, which is the main tool for the stu
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