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 research deals with metaphors as being one of the primary means used by Lyudmila Ulitskaya when writing the novel " Sincerely Yours Shurik ", to form diverse and multifaceted collective female images of representatives of the classic psychological patterns presented in the work. This research reflects the results of the study related to the work of Lyudmila Yevkinevna Ulitskaya, an actress of modern Russian prose. The novel "The Sincerely to You Shorek" is one of Ludmila Ulitskaya's creations (the year of writing - 2003), which, like her other works, is distinguished by a unique presentation style, rich vocabulary, lexical and semantic diversity, and a special style of writing. writer. The main objective of the research is to look at th
... Show MoreThe dispersion relation of linear quantum ion acoustic waves is derivate according to a fluid approach that depends on the kinetic description of the systems of charged particles model. We discussed the dispersion relation by changing its parameters and graphically represented. We found through graphs that there is full agreement with previous studies on the subject of interest. That motivates us to discuss the dispersion relation of waves depending on the original basic parameters that implicitly involved in the relationship which change the relationship by one way or another, such as electron Fermi temperature and the density at equilibrium state.
The objectives of this research are to determine and find out the reality of crops structure of greenhouses in association of Al-Watan in order to stand on the optimal use of economic resources available for the purpose of reaching a crop structure optimization of the farm that achieves maximize profit and gross and net farm incomes , using the method of linear programming to choose the farm optimal plan with the highest net income , as well as identifying production plans farm efficient with (income - deviation) optimal (E-A) of the Association and derived, which takes into account the margin risk wich derived from each plan using the model( MOTAD), as a model of models of linear programming alternative programming m
... Show MoreThis research aims to study the radiation concentration distribution of the old District of Najaf (Iraq), where 15 samples were taken from featured sites in the District, which represents archaeological, religious, and heritage sites. Track detector CR-39 was used to calculate the concentration of three different soil weights for each sample site after being exposed for a month. Geographical information systems (GIS) were used to distribute the radioactive concentration on the sites of the samples, where two interpolation methods, namely the inverse distance weight method (IDW) and the triangle irregular network method (NIT), to study the distribution of the radioactivity concentration. The study showed that the western part of the district
... Show MoreThe extraction of Basil oil from Iraqi Ocimum basillicum leaves using n-hexane and petroleum ether as organic solvents were studied and compared. The concentration of oil has been determined in a variety of extraction temperatures and agitation speed. The solvent to solid ratio effect has been studied in order to evaluate the concentration of Ocimum basillicum oil. The optimum experimental conditions for the oil extraction were established as follows: n-hexane as organic solvent, 60 °C extraction temperature, 300 rpm agitation speed and 40:1mL:g amount of solvent to solid ratio.
Investigation of the adsorption of Chromium (VI) on Fe3O4 is carried out using batch scale experiments according to statistical design using a software program minitab17 (Box-Behnken design). Experiments were carried out as per Box-Behnken design with four input parameters such as pH (2-8), initial concentration (50–150mg/L), adsorbent dosage (0.05–0.3 g) and time of adsorption (10–60min). The better conditions were showed at pH: 2; contact time: 60 min; chromium concentration: 50 mg/L and magnetite dosage: 0.3 g for maximum Chromium (VI) removal of (98.95%) with an error of 1.08%. The three models (Freundlich, Langmuir, and Temkin) were fitted to experimental data, Langmuir isotherm has bette
... Show MoreThe Islamic Issue did not rise the “widespread arguments” in contemporary times, just as the issue of applying Islamic Law. Just as the Islamic forces used this purpose, or employed it during their march to reach to power by adopting the sacred as motivation towered the power, or control the governance. However, the reality show that this goal remained within the boundaries of slogans in the sense of a teleological slogan, and did not go beyond the limits of advocacy or arrangement as the primary source of legislation with differences of teleological reasoning, in a manner that reflected an intellectual problem about the validity of the use of this concept or the ability to apply and enforce the law in today's world, to impose
... Show MoreThe current research deals with the dialectical relationship resulting from the conflict in the violent combination and construction of the living ( the actor)and the dead (the item) in the structure of the Sinography construction and the emergence of the theatrical play space , which can be summed up by the following question: what is the nature of the dialectical relationship between the living (the actor) and the dead( the item) in the Sinography creation, which limited the research in a central objective : to identify the controversy of the living (actor) and the dead (item) in the performance unit of the theatrical scene . The research, in its objective limits set forth in its methodological framework, analyzes this controversy in o
... Show MoreThe aqueous extract of Citrullius colocynthis dried seeds (160 ?g/ml) was in vitro evaluated for its effect on phagocytic index (PI) and lymphocyte transformation index (LTI) of blood cells obtained from 30 apparently healthy blood donors (15 males and 15 females). The PI was further in vivo evaluated in cells of peritone, spleen and liver of mice treated with the extract at a dose of 0.64 mg/kg. The results revealed that in in vitro study, phagocytic cells treated with the extract showed a significant increased percentage as compared with untreated cells (60.0 vs. 44.1%). Phagocytes obtained from peritone (44.1 vs. 30.0%) and spleen (45.6 vs. 39.6 %) of treated and untreated mice behaved in a similar manner, while liver phagocytes showed n
... Show MoreThis study aimed to detect of contamination of milk and local soft cheese with Staphylococcus aureus and their enterotoxins with attempt to detect the enterotoxin genes in some isolates of this bacteria. A total of 120 samples, 76 of raw milk and 44 of soft cheese were collected from different markets of Baghdad city. Enterotoxins in these samples were detected by VIDAS Set 2 system and it was found that enterotoxin A is present in a rate of 44.74% in milk samples and in a rate 54.50% in cheese samples. While other enterotoxins B, C, D, E were not found in any rate in any samples.
Through the study 60 isolates obtained from milk and cheeses were identified as Staphylococcus aureus by cultural, morphological and biochemical test by u