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 surgery Keywords: Non-surgical treatment of anal fissure, fissure in ano, sphicterotomy,botulinum toxin in anal fissures, glyceryl trinitrate. Chemical sphincteratomy, pharmacological sphincteratomy.
This paper aims to give an overview of acculturation in the literature by means of its explicit definitions, main characteristics, and categorical process. It also foreshadows the significance of acquiring novice culture with particular connection to second language acquisition. Schumann and John Berry underscored acculturation each with its own model of acculturation. In the case of this review, you will realize that Schumann's two main aspects are firmly rooted in berry's model of acculturation as an exclusive description in relation to second language acquisition. Steven Krashen outlined acquiring language from the intellectual and linguistic view of learning, whereas Micheal Long demanded for communication in social perspective. It has
... Show MorePreserving and saving energy have never been more important, thus the requirement for more effective and efficient heat exchangers has never been more important. However, in order to pave the way for the proposal of a truly efficient technique, there is a need to understand the shortcomings and strengths of various aspects of heat transfer techniques. This review aims to systematically identify these characteristics two of the most popular passive heat transfer techniques: nanofluids and helically coiled tubes. The review indicated that nanoparticles improve thermal conductivity of base fluid and that the nanoparticle size, as well as the concentrations of the nanoparticles plays a major role in the effectiveness of the nanofluids.
... Show MoreHS Saeed, SS Abdul-Jabbar, SG Mohammed, EA Abed, HS Ibrahem, Solid State Technology, 2020
Given the importance of ecology and its entry into various fields in general and the urban environment particularly; ecological cities take wide ranges of application at multiple regional and global levels. However, it repeatedly noted that there was a state of cognitive confusion and overlapping in the term ecology comes from the diversity of implementation within several disciplines. Architects, designers, and planners have instilled biological development directly into the formal principles as well as the social structures of the ecological cities. Therefore, the research presents a rapid review of the most relevant areas that dealt with the ecological cities by research and analys
The present study analyzes the effect of couple stress fluid (CSF) with the activity of connected inclined magnetic field (IMF) of a non-uniform channel (NUC) through a porous medium (PM), taking into account the sliding speed effect on channel walls and the effect of nonlinear particle size, applying long wavelength and low Reynolds count estimates. The mathematical expressions of axial velocity, stream function, mechanical effect and increase in pressure have been analytically determined. The effect of the physical parameter is included in the present model in the computational results. The results of this algorithm have been presented in chart form by applying the mathematical program.
Success in selecting the best among the sources of supply is one of the most important factors in the efficiency of the procurement activity in the company, because the proper selection of the source of the supply significantly affect the achievement of what is desired by the factors of quality, quantity, price and service, and the ability of the competent supplier to meet everything associated with this Factors of commitments, hereby supporting the procurement function's efforts to fully discharge its responsibilities, and in view of adopting of Al-Furat company quality management system by applying the standards of ISO (9001: 2015) and purpose of getting the on-demand benefits from the application of international standards reg
... Show MoreObjective(s) : This study aimed at evaluating the seroprevalence of anti -HCV and studying the
correlation between hemophilia and risk factors for acquiring HCV such as age , marital status &
occupation among hemophilic patients .
Methodology : 210 hemophilic patients in children welfare teaching hospital/medical city/Baghdad–Iraq
(hemophilia center) were investigated using prepared questionnaire and tested for HCV infection, those
were measuring patient’s age, hemophilia types and severity, marital status, residency and history of
previous HCV infection .
Results : Most hemophilic patients were hemophilia A at severe , hemophilia was at age group 20 – 29
years , the majority of patients were unmarried a
Obesity is a worldwide health complication. In 2014, 600 million adults and 42 million kids, less than five years of age, were obese. It is a hyperassembly of energy in the form of adipose tissues which has worse effects on health. The major factors of the obesity epidemic are: heavy meal which is rich in lipids, carbohydrates resulting in overweight and eventually obesity, and a decrease in physical activity that leads to defects in calorie conception. In health care facilities ferritin assay is used as a screening test to detect iron deficiency; however, its reliability in obesity has been questioned. The present study aimed to assess and compare the incidence of obesity, hyperferritinemia, hyperlipidemia, and hypouricemia among middle-ag
... Show MoreThis research aims to know the reality of succession planning in the researched organization and how it occupies the important jobs in the organization and its readiness for sudden and urgent events that lead to the vacancy of these jobs, and the importance of this research is that it is one of the rare Arab and Iraqi studies and research in this field, as it is one of the first researches It deals with the reality of succession planning in light of the retirement law No. (26) of 2019, and the research problem was the absence of consecutive planning programs and the weak preparation of suitable candidates to face sudden and urgent conditions as replacements for current leaders who occupy the leading and key positions in the depar
... Show More