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.
In this work, two cone-inverted cylindrical and cross-hybrid dielectric resonator antennas are stacked and excited by the coaxial probe method with an operating standard resonant frequency of 5.438 GHz. A drawback of these standard Dielectric Resonator Antennas (DRAs) is their narrow bandwidth. For good antenna performance, a stacked DR geometry and a thick dielectric substrate having a low dielectric constant are desired since this provides large bandwidth, better radiation power, reduces conductor loss and nonappearance of surface waves. Many approaches, such as changing the shape of the dielectric resonator, have been used to enhance bandwidth. Using DRA, having the lowest dielectric constant, increases the bandwidth and the electroma
... Show MoreObjectives: To assess the qualifications and performance of newly graduated pharmacists and explore factors that affect their performance in public hospitals. Methods: This qualitative study included face-to-face, semi-structured interviews with hospital practitioner pharmacists. It was conducted between March and May 2023 in Kerbala province, Iraq. The participating pharmacists were selected purposefully because they had three or more years of work experience at governmental hospitals. The audio-recording interviews were transcribed. Thematic analyses were used to generate themes and subthemes from the interviews. Results: Twenty-seven hospital pharmacists participated in this study. The study found that there are several factors t
... Show MoreLanguage as a means of communication has long been the concern of many conversation analysts in their studies such as: Sacks et al. (1974), Schegloff et al. (1977), Duncan (1972), Grice (1975) and Burton (1980). Burton has attempted analyzing the first ten transitions of the play “The Dumb Waiter” for mere a presentation of her approach. This paper aims at analyzing the conversational structure of forum on the subject of literary fiction and genre fiction by applying Burton’s model (1980) of analysis to answer the question to what extent this model is applicable in analyzing the presented text. The findings of the investigation have proved the applicability of the structure of conversation formulated by Burton (1980) in her model wit
... Show MoreAn electrolytic process for the removal of Zn(II) from aqueous solution using a parallel amalgamated copper screens cathode operated in the flow through mode is proposed. The current-potential curves recorded at a rotating amalgamated copper disc electrode were used to determine diffusion coefficient of Zn(II). The performance of electrolytic reactor was investigated by using different flow rates at initial zinc ion concentration(48 mg/L). Taking into account the residential Zn(II) concentration, the best results were obtained for cathode potential of (-1.35 V vs. SCE) at flow rate (320 L/h). Zinc ion concentration was found to decrease from 48 mg/L to 1 mg/L during 120 min. of electrolysis. The experimental data are well correlate
... Show MoreLet A be a unital algebra, a Banach algebra module M is strongly fully stable Banach A-module relative to ideal K of A, if for every submodule N of M and for each multiplier θ : N → M such that θ(N) ⊆ N ∩ KM. In this paper, we adopt the concept of strongly fully stable Banach Algebra modules relative to an ideal which generalizes that of fully stable Banach Algebra modules and we study the properties and characterizations of strongly fully stable Banach A-module relative to ideal K of A.
Anomaly detection is still a difficult task. To address this problem, we propose to strengthen DBSCAN algorithm for the data by converting all data to the graph concept frame (CFG). As is well known that the work DBSCAN method used to compile the data set belong to the same species in a while it will be considered in the external behavior of the cluster as a noise or anomalies. It can detect anomalies by DBSCAN algorithm can detect abnormal points that are far from certain set threshold (extremism). However, the abnormalities are not those cases, abnormal and unusual or far from a specific group, There is a type of data that is do not happen repeatedly, but are considered abnormal for the group of known. The analysis showed DBSCAN using the
... Show MoreThis study deals with an important area in the field of linguistics, namely person deixis.
The study aims at: (1) Describing the notion of deixis, its importance, and its place in the field
of linguistics, (2) Presenting a detailed illustration of person deixis, and (3) Conducting an
analysis of person deixis in one of Synge‟s plays Riders to The Sea according to Levinson‟s
model. The most important aim of these three is the third one (the analysis). To achieve this
aim, the researcher depends on Levinson‟s (1983) descriptive approach. According to the
descriptive approach of deixis, the category of person deixis can be defined as the encoding of
the participant roles in the speech situation. This encoding is r
Locking of the knee is a one of the commonest orthopedic outpatient presentation. This patient usually need magnetic resonance imaging (MRI) when there is suspected lesion in the soft tissue clinically. Meniscal tears is the first differential diagnosis when accompany with painful knee. (1, 2)Giant cell tumor (GCT) is benign a localized nodular tenosynovitis often occur in the tendon sheath , Mostly involve the hand tendons in middle age group between 30 and 50 years old , female affect more than male.(3,4) The WHO defines two well-known kinds of giant cell tumor: (1) pigmented villonodular synovitis ( generalized type), which mainly involve the joints of the lower limb and (2) giant cell tumor of the tendon sheath ( localized type)
... Show MoreThe systems cooling hybrid solar uses solar collector to convert solar energy into the source of heat for roasting Refrigerant outside of the compressor and this process helps in the transformation of Refrigerant from the gas to a liquid state in two-thirds the top of the condenser instead of two-thirds the bottom of the condenser as in Conventional cooling systems and this in turn reduces the energy necessary to lead the process of cooling. The system cooling hybrid use with a capacity of 1 ton and Refrigerant type R22 and the value of current drawn by the system limits (3.9-4.2A), the same value of electric current calculated by the system are Conventional within this atmosphere of Iraq, and after taking different readings
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