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.
The main problem of the current study concentrates on applying critical discourse analysis to examine textual, discoursal and social features of reduplication in some selected English newspaper headlines. The main aim of the current study is to analyze the linguistic features of reduplication by adopting Fairclough's three-dimensional model (2001). This study sets forth the following hypotheses: (1) English headline – newspapers comprise various textual, discoursal and social features ;(2)the model of analysis is best suited for the current study.To achieve the aims and verify the hypotheses, a critical discourse analysis approach is used represented by Fairclough's socio-cultural approach (2001).The present study has examined the use of
... Show More
Prepositions have a key function, which is to associate parts of a sentence, called letters In addition, it adds the meanings of the verbs to the names, ie reached by them, and called by the coffin characters Qualities..
I chose to search for the meaning of the preposition "from" in Surat Maryam to know its meanings in terms of originality and expansion, so the title of the research (the meanings of preposition "from" in terms of originality and expansion in Surat Maryam model(
Objective(s): To Evaluate Diabetes self –management among patients in Baghdad City and to compare
between these patients self-management relative to the type of the disease.
Methodology: A descriptive design was conducted in Baghdad city, started from November 16th 2017 to the
end of May 17 th 2018 in order to evaluate Diabetes self-management. Purposive (non-probability) sample,
which was consisted of (120) patients who were diagnosed with D.M. The sample is comprised of (60) patient
with diabetes type I and (60) patient with diabetes type II. It is consisted of (60) male and (60) female. A
questionnaire is constructed for the purpose of the study. It is composed of (42) items. Reliability and validity of
the ques
(1)
(29)
(3)
(1)
A new modified differential evolution algorithm DE-BEA, is proposed to improve the reliability of the standard DE/current-to-rand/1/bin by implementing a new mutation scheme inspired by the bacterial evolutionary algorithm (BEA). The crossover and the selection schemes of the DE method are also modified to fit the new DE-BEA mechanism. The new scheme diversifies the population by applying to all the individuals a segment based scheme that generates multiple copies (clones) from each individual one-by-one and applies the BEA segment-wise mechanism. These new steps are embedded in the DE/current-to-rand/bin scheme. The performance of the new algorithm has been compared with several DE variants over eighteen benchmark functions including sever
... Show More
(3)
(2)
(6)
(3)
An 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 More