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 work is concerned with designing two types of controllers, a PID and a Fuzzy PID, to be used
for flying and stabilizing a quadcopter. The designed controllers have been tuned, tested, and
compared using two performance indices which are the Integral Square Error (ISE) and the Integral
Absolute Error (IAE), and also some response characteristics like the rise time, overshoot, settling
time, and the steady state error. To try and test the controllers, a quadcopter mathematical model has
been developed. The model concentrated on the rotational dynamics of the quadcopter, i.e. the roll,
pitch, and yaw variables. The work has been simulated with “MATLAB”. To make testing the
simulated model and the controllers m
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The deficiency in the nurse staff in the health organizations consider an important problem that must be studied and solved basically , not only because it affect on the health organization and it's strategic goals , but also it affect the human being and it's health which can't be substituted with anything or delayed in it's treatment ,This research aims to necessary for health organizations to strategically help in maintaining the nurse staff and to keep that in it's strategic orientation and it's mission , moreover , the health organizations must study the reality of the nurse in the health organizations and know the causes beyond leaving the nurse staff the nurse job , and then remove
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Abstract [email protected] Background: Acute Traumatic Stress Disorder (ATSD) might be complicated by Post Traumatic Stress Disorder (PTSD). Psychological First Aid (PFA) said to be helpful to reduce the possibility of reduction of ASD and PTSD symptoms. PFA is simple procedure to deliver help & support to victims, may be by some one close to him, quietly and professionally. Iraq has and is still experiencing, continuous traumatic stresses. ATSD is especially seen in war such as during the Gulf War, Embargo and nowadays under the current American occupation. With the extreme shortage of recourses and the given late priority to psychological problems and intervention have disastrous consequences on the psycho-social wellbeing of peop
... Show MoreIn this work chemical vapor deposition method (CVD) for the production of carbon nanotubes (CNTs) have been improved by the addition of S. Steel mesh container (SSMC) inside which the catalyst (Fe/Al2O3) was placed. Scanning electron microscopy (SEM) investigation method used to study nanotubes produced, showed that high yield of two types of (CNTs) obtained, single wall carbon nanotube (SWCNTs) with diameter and length of less than 50nm and several micrometers respectively and nanocoil tubes with a diameter and length of less than 100nm and several micrometers respectively. The chemical analysis of (CNTs) reveals that the main component is carbon (94%) and a little amount of Al (0.32%), Fe (2.22%) the reminder is oxygen. It was also fou
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Pricing has an important position among the elements of marketing mixture (4ps) as it represents revenues that in turn represent one of the important pillars' for resources affecting on organizations sustainability and development , and the failure in determining prices and their strategies has a dangerous effect on the organizations reality and future as a whole . from this point, this is what from the focus of the research problem,which centered on how to get companies to critical price that satisfies customers and achieve corporate objectives.
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Dylan Thomas (1914-1953) is a modern poet belongs to the apocalyptic movement of the 1940's.This movement is influenced by the doctrines and techniques of surrealism.
Poetry for him should not be primarily concerned with man in society, but with the celebration of spiritual truth. It should bring to light the hidden causes, hence his personal interest is to strip darkness and explore the inward motives. To do this he uses a cluster of images: a constant building up and breaking down of images. His poetry depends on the romantic spontaneity, suggestiveness of the Symbolists and the the surrealists' mysterious liberation of the unconsciousness and
... Show MoreTelevision culture has become the most dangerous of our time. It manipulates with minds and hearts together; and forms consciousness. It transforms societies into actual forces rejecting certain principles by guiding the media landscape through visible connotations acceptable to the public; or provokes the citizen against elements that put a burden on the viewer or the public in order to create a positive reaction to the subject of combating terrorism by combining these ads in line with what the public wants of security and tranquility and a decent living after suffering from terrorism in the past years.
Therefore, this research deals with television advertisements as one of the most important fo
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The goal of the research is to develop a sustainable rating system for roadway projects in Iraq for all of the life cycle stages of the projects which are (planning, design, construction and operation and maintenance). This paper investigates the criteria and its weightings of the suggested roadway rating system depending on sustainable planning activities. The methodology started in suggesting a group of sustainable criteria for planning stage and then suggesting weights from (1-5) points for each one of it. After that data were collected by using a closed questionnaire directed to the roadway experts group in order to verify the criteria weightings based on the relative importance of the roadway related impacts
... Show MoreThe title takes its realistic connotations with its symbols, slogans and historical extensions in Iraq, also, the repercussions of the organic crisis that afflicted it for almost half a century, especially after the abortion of the July 14 Revolution and the spread of the culture of weapons, violence and death that we are living in Iraq nowadays.
The topic is suitable for critical analytical studies carried out by specialists in scientific and academic research centers and cultural institutions because they have an important feasibility at the strategic cultural level in Iraq, the Middle East and the world.
Research in Iraq has fallen to the extreme and is no longer effective, to the extent that it represents a severe cri
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