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.
Objective: The study aims to assess the knowledge and practices of mothers with hemophilia children type - A - ,
socio-economic status and association between mother demographic information with their knowledge and practices
toward their children in Azadi Teaching Hospital in Kirkuk.
Methodology: Descriptive study no probability (purposive) sample. Selected Fifty-five of mothers having hemophilia
children, started from November 2012 to May 2013. Study was carried out in the Azadi teaching hospital in
Kirkuk. By using questionnaire which consists from five parts include demographic characteristics for mother and
children, socio-economic, Knowledge and practices data gathered, by direct interview with the mothers in the
Background: Lateral cephalometric radiography is commonly used as a standard tool in orthodontic assessment and treatment planning. This study aimed to determine the tongue and surrounding space area in a sample of Iraqi adults with class I dental and skeletal pattern. Materials and methods: The study included thirty healthy subjects (15 males and 15 females) with an age ranged between 23-34 years and class I dental and skeletal pattern with no history of any sleep related disorders. The assessed cephalometric measurement included length and height of the tongue and position of hyoid bone from cervical line. Descriptive statistics were obtained for the data. Genders difference was evaluated by independent sample t-test. Results: There wer
... Show MoreThe inhibitive action of polyvinyl alcohol –sodium nitrite (PVASN) composite on the corrosion of mild steel in simulated cooling water (SCW) has been investigated by weight loss and potentiodynamic polarization. The effect of composite concentration (PVA/SN) , pH, and exposure time on corrosion rate of mild steel were verified using 2 levels factorial design and surface response analysis through weight loss approach, while the electrochemical measurements were used to study the behavior of mild steel in (SCW) with pH between 6 and 8 and in absence and presence of (PVA) in solution containing different concentration of NaNO2. It was verified that all three main variables studied were statistically significant while their interaction is
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ABSTRUCT
The main aim of this research has been associated with the study of relationship between competitive intelligence and strategic risk, and to deduct their specific trends, which are interpreted as predicted by research hypotheses according to a review of literature including prior studies. The basic theme of these hypotheses is related to the probability that declining levels of strategic risk and competitive positions of industrial companies is dependent upon the growing capacity to stay ahead of competitors in the market.
A purposive non-random
... Show MoreThis work is concerned with the vibration attenuation of a smart beam interacting with fluid using proportional-derivative PD control and adaptive approximation compensator AAC. The role of the AAC is to improve the PD performance by compensating for unmodelled dynamics using the concept of function approximation technique FAT. The key idea is to represent the unknown parameters using the weighting coefficient and basis function matrices/vectors. The weighting coefficient vector is updated using Lyapunov theory. This controller is applied to a flexible beam provided with surface bonded piezo-patches while the vibrating beam system is submerged in a fluid. Two main effects are considered: 1) axial stretching of the vibrating beam that leads
... Show MoreThis study aims to answer a significant problem of social sciences and philosophy: How do we construct an institutional reality such as diplomacy with an objective recognizable existence? The study assumes that the ability to build institutional reality is based on our biological capacity, as it takes different forms in all the institutions we construct. The study takes the theory of the American philosopher John Searle as an approach to examining the assumption. The study sums up important findings; cultures, although they share the biological capacity on which they produce institutional realities, differ in the form of the value standards on which the institutional realities are based. The study recommends the need of Arab social resea
... Show Moreالغرض من هذا العمل هو دراسة الفضاء الإسقاطي ثلاثي الأبعاد PG (3، P) حيث p = 4 باستخدام المعادلات الجبرية وجدنا النقاط والخطوط والمستويات وفي هذا الفضاء نبني (k، ℓ) -span وهي مجموعة من خطوط k لا يتقاطع اثنان منها. نثبت أن الحد الأقصى للكمال (k، ℓ) -span في PG (3،4) هو (17، ℓ) -span ، وهو ما يساوي جميع نقاط المساحة التي تسمى السبريد.
<span lang="EN-US">The fundamental of a downlink massive multiple-input multiple-output (MIMO) energy- issue efficiency strategy is known as minimum mean squared error (MMSE) implementation degrades the performance of a downlink massive MIMO energy-efficiency scheme, so some improvements are adding for this precoding scheme to improve its workthat is called our proposal solution as a proposed improved MMSE precoder (PIMP). The energy efficiency (EE) study has also taken into mind drastically lowering radiated power while maintaining high throughput and minimizing interference issues. We further find the tradeoff between spectral efficiency (SE) and EE although they coincide at the beginning but later their interests become con
... Show MoreThe research aimed at designing a teaching aid for learning backswing into handstand as well as identifying its effect on learning skill performance. The researchers hypothesized statistical differences between pre and post-tests in favor of the research group. They used the experimental method on six (13 – 16) year–old Baghdad club gymnasts. The researchers used the one group design in which all players perform pretests followed by special tests on the teaching aid than are tested posttests. The researchers conclude that the teaching aid positively affected learning the skill as well as the teaching aid was very good and endured the performance of all gymnasts. The researcher recommended making simi
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