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 right to property is one of the most prominent and most important of the fundamental rights that the individual enjoys, whether national or foreign, both of them have their own private property that may not be affected except for the requirements of the country's economic development or what is known as the public benefit, and the Iraqi legislator did not specify what is meant by the removal of foreign investment. Of the bilateral international agreements (BITS), as it determined its terms and methods, the properties of foreign investors may be expropriated in a direct and indirect way.
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The current research is concerned with studying the decisive answers which are considered quick and conclusive. These answers can effectively interrupt the opponent's argument and close the dialogue.This research is concentrated on deliberative methodology focusing on the decisive answer's activity and ending them through several completing and argument sides. This research consists of an introduction and three parts, the current introduction is focused the light on the concept of decisive answers and its uses in literature and the scarce of speech, and how to consider it with one dialogue description,that dialogue constitute by ? The first part is concerned with those answers through the deliberative methodology and classifying decisive
... Show MoreIn this paper a nonlinear adaptive control method is presented for a pH process, which is difficult to control due to the nonlinear and uncertainties. A theoretical and experimental investigation was conducted of the dynamic behavior of neutralization process in a continuous stirred tank reactor (CSTR). The process control was implemented using different control strategies, velocity form of PI control and nonlinear adaptive control. Through simulation studies it has been shown that the estimated parameters are in good agreement with the actual values and that the proposed adaptive controller has excellent tracking and regulation performance.
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The present research aimed to test the imagination of children, and may build sample consisted of (400) a baby and child, selected by random way of four Directorates (first Resafe, second Resafe ,first alkarkh , second alkarkh), in order to achieve the objective of research the tow researchers have a test of imagination and extract the virtual and honesty plants distinguish paragraphs and paragraphs and difficulty factor became the test consists of (32), statistical methods were used (Pearson correlation coefficient, coefficient of difficult passages, highlight paragraphs, correlation equation, an equation wrong Standard) the tow researchers have a number of recommendations and proposals.
Iraq is changing from the centralized system of governance to the decentralized system, which assumes devolution of more authorities to the local governments of Iraqi provinces and cities. This puts a responsibility on the academics to produce more research work on the best framework for this change, to ensure the best results. The main objective of this research is to suggest a policy for the decentralized transformation in domain of Urban and Regional Planning in Iraq. A suggested program for the transformation is involved in the paper as well, with analysis for the new relationships between different levels of planning authorities depending on democracy. In addition, a description for planning process flows from bottom to top.
Background: Neonatal seizures are the most common neurological emergency in newborns, often associated with significant mortality and long-term neurodevelopmental disabilities. The aim is to determine the incidence, etiological causes, and risk factors associated with neonatal seizures.Patients and Methods: This prospective case-control study was conducted over eight months, from January 1 to August 31, 2022, the study was conducted at the neonatal care unit of Children Welfare Teaching Hospital. Neonates who developed clinically recognizable seizures before 28 days of life in term infants, or up to 44 weeks corrected gestational age in preterm infants, were included. Data collection involved demographic information, prenatal, perin
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