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.
Abstract
Abstract has many advantages as has historically been one of the regions leading cultural centers . for centuries , it has been a center of commertial and financial operations in Iraq. it is also rich in archeological sites and natural resources, but because of its wars and implementation of urban development strategies are effective and sustainable , so contracted the secretariat of Baghdad with the company (khatib and scirntiffic) for the preparation of the comprehensive development plan for the city of Baghdad in 2030 and funded by the world bank and the fact that the plan was approved ( three stages of it ) and only one phase remains the fourth stage, which is under discussion the aim of the
... Show MoreThe researcher attempts to examine Barman model in acquiring the historical concepts among fourth-grade students at literary classrooms. To this end, the researcher held the null hypothesis, there is no significant difference between the experimental groups who was taught based on Barman model and the control group that taught based on the traditional method in acquiring the historical concepts on the post-test. To testify the effectiveness of Barman model, the researcher administered a questionnaire included (60) items on bunch of female-students who were selected from al-khamaeal preparatory school in al-hurriyah district in Baghdad. The author utilized different statistical tools to analyze the collected data. &
... Show MoreThe risk assessment for three pipelines belonging to the Basra Oil Company (X1, X2, X3), to develop an appropriate risk mitigation plan for each pipeline to address all high risks. Corrosion risks were assessed using a 5 * 5 matrix. Now, the risk assessment for X1 showed that the POF for internal corrosion is 5, which means that its risk is high due to salinity and the presence of CO, H2S and POF for external corrosion is 1 less than the corrosion, while for Flowline X2 the probability of internal corrosion is 4 and external is 4 because there is no Cathodic protection applied due to CO2, H2S and Flowline X3 have 8 leaks due to internal corrosion so the hazard rating was very high 5 and could be due to salinity, CO2, fluid flow rate
... Show MoreMagnetic Abrasive Finishing (MAF) is an advanced finishing method, which improves the quality of surfaces and performance of the products. The finishing technology for flat surfaces by MAF method is very economical in manufacturing fields an electromagnetic inductor was designed and manufactured for flat surface finishing formed in vertical milling machine. Magnetic abrasive powder was also produced under controlled condition. There are various parameters, such as the coil current, working gap, the volume of powder portion and feed rate, that are known to have a large impact on surface quality. This paper describes how Taguchi design of experiments is applied to find out important parameters influencing the surface quality generated during
... Show MoreThe financial analysis of the published financial statements is the means that enables businessmen, financial institutions, financial analysts and others to conduct their studies and conclusions to obtain information that helps them in the decision-making process, including decisions related to investment. National in making the decision on the investment activity, for the period from 2012 to 2018, through the information provided by the annual financial statements, by selecting a set of indicators provided by the financial statements, namely (liquidity ratio, activity percentage, profitability ratios) to measure the extent of this ability Indicators in determining their role in making an investment decision.
The purpose of the research is to present a proposed accounting system model for converting and aggregating accounting information within the framework of the differentiated accounting systems, and the research methodology consists of: The research problem is the existence of differentiated and dispersed accounting systems that operate within governmental economic units and at the same time seek to achieve a unified vision and goals for the organization, and the central research hypothesis is the possibility of conducting the process of conversion accounting information from the government accounting system to the unified accounting system, and then aggregate those systems. The research was conducted at the College of Administrat
... Show MoreThe purpose of this study is to diagnose factors that effect Thi-Qar behavioral intention to use internet. A sample of (127) internet users of university staff was taken in the study and were analyzed by using path analyze . The study concluded that there is a set of affecting correlation. It was founded that exogenous variables (gender, income, perceived fun, perceived usefulness, Image, and ease of use) has significant effect on endogenous (behavioral intention) . The result of analysis indicated that image hopeful gained users comes first, ease of use secondly, perceived fan and perceived usefulness on (dependent variables (daily internet usage and diversity of internet usage. Implication of these result are discussed . the st
... Show MoreThere is a great operational risk to control the day-to-day management in water treatment plants, so water companies are looking for solutions to predict how the treatment processes may be improved due to the increased pressure to remain competitive. This study focused on the mathematical modeling of water treatment processes with the primary motivation to provide tools that can be used to predict the performance of the treatment to enable better control of uncertainty and risk. This research included choosing the most important variables affecting quality standards using the correlation test. According to this test, it was found that the important parameters of raw water: Total Hardn
The current study was carried out to study a high injection dose of the ethanolic extract thymus vulgaris leaf (500 ug /Kg) against the immune response combination with partially purified extracted Lipopolysaccharide ( LPS) from Proteus mirablis.Study groups were included four groups; Group I :treated with normal saline. Group II : treated with LPS antigen, Group III: injected subcutaneously ((500 ug /Kg) from ethanolic extract thymus vulgaris, group IV : injected subcutaneously (500 ug /Kg) from ethanolic extract thymus vulgaris leaf and LPS antigen, the immunological assays were measured through the phagocytic activity as (non specific immunity) after day 8 by using the phagocytic activity index.After day I4 the lymphocyte proliferations
... Show MoreThis study aimed to extract, purify, and characterize the protease of local Okra Abelmoschus esculentus pods. The extraction process was conducted using ten extraction solutions with different pH and ionic strength values. Phosphate buffer solution with (pH 7, 0.05M, containing 2% sodium chloride) gave the highest activity which was (7.2 Unit/ml) as compared to other solutions, which ranged from 0.8-5.9 Unit/ml. The extracted enzyme purified by several stages. Being, precipitation by gradual addition of Ammonium sulphate from 20 to 85% saturation, then the precipitated enzyme was dialyzed and fractionated through DEAE-Cellulose (22X1.1cm), the enzymic fractions were pooled. The specific activity, purification fold and the enzyme yield value
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