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.
The dynamic development of computer and software technology in recent years was accompanied by the expansion and widespread implementation of artificial intelligence (AI) based methods in many aspects of human life. A prominent field where rapid progress was observed are high‐throughput methods in biology that generate big amounts of data that need to be processed and analyzed. Therefore, AI methods are more and more applied in the biomedical field, among others for RNA‐protein binding sites prediction, DNA sequence function prediction, protein‐protein interaction prediction, or biomedical image classification. Stem cells are widely used in biomedical research, e.g., leukemia or other disease studies. Our proposed approach of
... Show MoreDue to the increasing interest in the quality of auditing by writers, researchers and regulators of the auditing profession. The matter necessitated a statement of the extent to which the auditor practices professional skepticism, because of its significant impact in discovering errors and material misrepresentations contained in the financial statements in order to give the financial community confidence in them and the success of the audit process. The research aims to clarify the concept and importance of the practice of professional skepticism and its effect on the quality of the auditor's performance in Iraq. To achieve the research objectives, the two re
... Show MoreThe research aims to apply one of the techniques of management accounting, which is the Quality Function Deployment(QFD) on the Pepsi product in Baghdad Soft Drinks Company and to determine the technical requirements objectively that have been applied in practice in Baghdad Soft Drinks Company / a private shareholding company, as it focuses on meeting the quality requirements and achieving positive quality to provide a product It meets the requirements of current and future customers, hence the importance of research that indicates that the Quality Function Deployment(QFD) is a useful tool to develop the requirements of new products, being a design process driven by customers through their voices, and thus contribute to achieve a competi
... Show MoreThe importance of social exclusion lies in the psychological problems that cause problems in social relations and mental-physical health. For this reason, the researcher set three goals for the current research: identifying the level of social exclusion among people infected with the Coronavirus. The incubation period of the virus. Social exclusion and its relationship to the duration of incubation of the disease among people infected with the Coronavirus. The result showed that the research sample does not suffer from social exclusion. The mean value for the period from
(8-14) days is the highest value followed by the period (1-7) days and the period
(14 days or more) comes at the end. There is no statistically sig
... Show MoreMany behavioral researchers pointed out the importance of relaxation techniques in the treatment of different psychological disorders where find the importance of these techniques in reducing anxiety and stress and the resulted of behaviors and habits, with the development of these techniques are being used to gain public health, whether mental health or physical or mentality, and one of these techniques is music therapy that reduces tension and anxiety and operates a state of relaxation, which is used in the treatment of patients of dental clinic.
Re
... Show MoreHighway embankments stability during its service period represents an important factor for the safety of highway users and vehicles. Consequently, the cost of construction of these embankments should be adequate to maintain the safety and durability during this period through proper estimation of the loading on asphalt pavement, slope stability, horizontal and vertical deformation, etc. Slope stability of the embankment mainly depends on the shear strength of the soil layers materials; this shear strength is affected by the water table level through the contribution of the capillary water. Negative pore water pressure above the water table level evolves matric suction in the unsaturated zone above water table; this matric suction increases
... Show MoreThis research study focuses on fundamental questions. It deals with the content of the critical reviews through which the most important sources that undermine the renaissance of the Islamic human society can be concluded. It is the vague fetishization of the sacred between religion, politics, and ideas, which members of society live in and which raised the dust of closed-minded fanaticism that led to the return of deviant extremism. It is oppression, violence, and domination, all of which are professional tools in the manufacture of the ideology of extremism in all its forms. Here, the idea matured in giving a human, intellectual and philosophical overview that mixed the required drawing in the formulation of scientific cont
... Show MoreMany problems are facing the installation of piles group in laboratory testing and the errors in results of load and settlement are measured experimentally may be happened due to select inadequate method of installation of piles group. There are three main methods of installation in-flight, pre-jacking and hammering methods. In order to find the correction factor between these methods the laboratory model tests were conducted on small-scale models. The parameters studied were the methods of installation (in-flight, pre-jacking and hammering method), the number of piles and in sandy soil in loose state. The results of experimental work show that the increase in the number of piles value led to increase in load carrying ca
... Show MoreWorld statistics proved that the most of work dangerous accidents, which causes death, are occurred in the construction works. These accidents related to many causes such as loss of workers experience and ignoring rules of safety requirements, especially young workers. Due to the risk of accidents that may occur in the site of work, the idea of this study crystallized to show the relationship between the age of worker and number of injuries and accidents, to identify the causes of these injuries, and to put the appropriate solutions to avoid or reduce the risk of work injuries. Also, the research shows the main principles of safety requirements to forming a clear picture about the subject of the study. A questioner form was prepared to c
... Show MoreThis research aim to recognize
satisfy of life in the university's student and balance in satisfy of life
according to two type aveirable sex specific and find type and
relationship's director between satisfy of life and character big factors.
and known hom much that Factors in satisfy of life, the research sample
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Baghdad's University, researcher bult scale of Costa &McCrae Fore the
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