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 effects of solar radiation pressure at several satellite (near Earth orbit satellite, low Earth orbit satellite, medium Earth orbit satellite and high Earth orbit satellite ) have been investigated. Computer simulation of the equation of motion with perturbations using step-by-step integration (Cowell's method) designed by matlab a 7.4 where using Jacobian matrix method to increase the accuracy of result.
Abstract
The research seeks to shed light on green accounting information systems, analyze them, identify sustainability reporting and how to improve it, as well as study the importance of the Iraqi oil sector, analyze it, and work on applying green accounting information systems in order to improve the quality of sustainability reporting. Oil as a branch of the General Corporation for the Distribution of Oil and Gas Products to apply the practical aspect and prove the hypothesis of the research. Explaining the company's role in improving environmental conditions
Several studies have indicated an unprecedented increase in the number of Arab youth who watch music videos. It is also a custom in Arab countries to broadcast songs at their happy parties such as weddings, engagements and birthdays. We see that guests and party owners interact by dancing and singing with the songs, while the viewership rates of Arab music videos have reached millions on YouTube. The researcher decided to study the image of women through the lyrics of these songs, due to their importance in shaping the image of women in the minds of young people and shaping the (self-image) of young women. Twenty songs were selected from the most watched songs on YouTube for the year 2024, and it was found that the negative qualities of t
... Show Moreتكمن أهمية البحث من الاستفادة من تمرينات الخاصة بمساعدة استعمال أي جهاز تدريبي مثل استعمال جهاز (Vertimax) فإِنَّ هذهِ التدريبات تساعد في تطوير التحمل الخاص وفقًا لما يتطور من قدرات بدنية باستعمال هذا الجهاز، ومن هنا برزت مشكلة البحث انه من المهم للاعب ان يعمل على الروافع الجسم للحصول على اداء افضل في عملية الرمي والحصول على افضل انجاز لهذة الفعالية باستعمال جهاز تدريبي جديد حيث يسلط مقاومات متعددة في ان وا
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Objective: to assessthe impact of psychological and social climacteric changes on quality of life among
middle age women in Baghdad city
Methodology: : A descriptive analytic study was conducted to study the quality of life among middle age
women due topsychological and social climacteric changes from February 2013- July 2013. A purposive
sampleconsisted of three hundred (300) womenaged (40-65) years who were attending health centers in two
sectors in Baghdad / AL- Russafa andAL- karhk . The data were collected through using interview technique ,
and questionnaire format , which comprises two parts, first part consist (socio-demographic characteristic , the
second part quality of life domains (psychological and socia
In this research we investigated the corrosion behavior of the commertialy pure titanium and Ti-6Al-4V alloy that coated with hydroxyapatite by electrochemical deposition with applied voltage (6,9,12) Volt from aqueous solution containing Ca(NO3)2.H2O =7.0 gm/l , (NH4)2HPO4 =3.5 gm/l , Na(NO3)2 = 8.5 gm/l in order to improve the bonding strength of hydroxyapetite and medical metals and alloys and increasing the biocompatibility. The coating layer morphology was investigated by XRD, Optical microscope , and SEM tests, the corrosio tests was made by use senthesys simulated body fluid (SBF) , and we found that the propreate voltage for coatint on Ti was 9 Volt and for Ti-6Al-4Vwas12Volt.
The γ- mixing ratios of γ- transitions from levels of 56Fe populated in reaction are calculated using least square fitting program for the first time in the case of pure and mixed transitions the results obtained have been compound with γ Values determined by other methods .The comparison shows that the agreement is good this confirmed the valilety of this method in calculating of values for such γ- transitions key word: γ- transition ,Multipole mixing ratios ,Least square fitting method.
African-American writers during the 19th century wrote in the shadow of the prominent romance, sentimental, and domestic fiction. Harriet Wilson’s Our Nig (1859) reflects an “alternative social character”, for the female protagonist suffers racism in the free North, because she is a mulatto child. Through depicting the life of free blacks, who supposedly lives a better life than Southern slaves, Wilson exposes how she has actually lived and sensed life in antebellum America. According to Raymond Williams (2011), there are two kinds of literary writings. The first represents the general tendency of the age, and he calls it “dominant social character”; representing the majority content of both the public writing and speaking. But, a
... Show MoreBackground: Postpartum hemorrhage is an important cause of maternal morbidity and mortality. Considerable difference of opinion exist regarding the optimal approach to the management of the 3rd stage of labour, practice varies between countries &between units.Objectives: To evaluate the effectiveness of intra umbilical vein injection of oxytocin and umbilical cord driange in shortening the duration of third stage of labour.Patient and Methods: In this randomized controlled study, 100 women were enrolled in this study they divided into three groups. (Group 1 ,N =30 )received 20 units of oxytocin diluted in 20 ml 0.9% saline solution injected in the umbilical vein after clamping.(Group 2, N = 34) placental cord drainage.(Group 3,
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The paper aims to measure and analysis the impact Public Spending on Iraq economy (Kaldor Variables).
(variables of the magic square Kaldor) and them in after 2003.
The paper adopted econometric Methods to test the stationarity of the Variables under consideration. For the period (2005-2016) by using multiple regression and estimation the Impulse response function (IRF), by adopting Eviews 10 program.
The results of Impulse response function for the following five-years after the period under consideration reflexes that public expenditure (PEX) was fluctuating between positive and negative in all the variables of the research and this shows the fragility of the performance of fiscal policy in Iraq.
T
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