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.
Increasing hydrocarbon recovery from tight reservoirs is an essential goal of oil industry in the recent years. Building real dynamic simulation models and selecting and designing suitable development strategies for such reservoirs need basically to construct accurate structural static model construction. The uncertainties in building 3-D reservoir models are a real challenge for such micro to nano pore scale structure. Based on data from 24 wells distributed throughout the Sadi tight formation. An application of building a 3-D static model for a tight limestone oil reservoir in Iraq is presented in this study. The most common uncertainties confronted while building the model were illustrated. Such as accurate estimations of cut-off permeab
... Show MoreEnhancement of the performance for hybrid solar air conditioning system was presented in this paper. The refrigerant temperature leaving the condenser was controlled using three-way valve, this valve was installed after the compressor to regulate refrigerant flow rate towards the solar system. A control system using data logger, sensors and computer was proposed to set the opening valve ratio. The function of control program using LabVIEW software is to obtain a minimum refrigerant temperature from the condenser outlet to enhance the overall COP of the unit by increasing the degree of subcooled refrigerant. A variable load electrical heater with coiled pipe was used instead of the solar collector and the storage tank to simulate the sola
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Background: Congenital club foot is a complex deformity of foot .It is a collection of different abnormalities, with different etiologies. Consequently, Severity varies with difficulties in evaluating treatment strategies with outcome results. The treatment of congenital club foot remains controversial. Usually, the orthopedist's goal is to obtain anatomically and functionally normal feet in all patients. Objective: To asses short term follow up result of conservatively treated club feet in relation to the age of initial casting by Ponseti technique. Methods :A cross sectional observational study with some comparative content done in Al-kindy
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Cryptographic applications demand much more of a pseudo-random-sequence
generator than do most other applications. Cryptographic randomness does not mean just
statistical randomness, although that is part of it. For a sequence to be cryptographically
secure pseudo-random, it must be unpredictable.
The random sequences should satisfy the basic randomness postulates; one of them is
the run postulate (sequences of the same bit). These sequences should have about the same
number of ones and zeros, about half the runs should be of length one, one quarter of length
two, one eighth of length three, and so on.The distribution of run lengths for zeros and ones
should be the same. These properties can be measured determinis
A revised checklist of the robber fly genera (Diptera, Asilidae) was given during this study in Iraq. The investigation showed (21) genera belonging to seven subfamilies, two genera new recorded to entomofauna of Iraq (Promachus Loew, 1848 and Genus: Dysmacus Loew, 1860). Eight genera showed in this investigation and eleven genera were recorded previously to Iraq.
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This paper examines the change in planning pattern In Lebanon, which relies on vehicles as a semi-single mode of transport, and directing it towards re-shaping the city and introducing concepts of "smooth or flexible" mobility in its schemes; the concept of a "compact city" with an infrastructure based on a flexible mobility culture. Taking into consideration environmental, economical and health risks of the existing model, the paper focuses on the four foundations of the concepts of "city based on culture flexible mobility, "and provides a SWOT analysis to encourage for a shift in the planning methodology.
Film and literature exchanges it’s influences since the early beginning of the motion pictures appearance .it was a phenomenon in other genres such as theatre ,short stories and novels .the film used out of this interaction with literature the content , themes and subjects whish were more attached to the society. based on that , the film gains it’s successes and wide spread of influences on it’s audiences who became more familiar with the motion picture style.Astrok , the French film critic wrote about “Camera the pain “ and called it as the a way of writing in the future .he was talking about the future’s role of the film .It is the importance of the film in the creation and documenting the life and its various fields.Becaus
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