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 addition to the primary treatment, biological treatment is used to reduce inorganic and organic components in the wastewater. The separation of biomass from treated wastewater is usually important to meet the effluent disposal requirements, so the MBBR system has been one of the most important modern technologies that use plastic tankers to transport biomass with wastewater, which works in pure biofilm, at low concentrations of suspended solids. However, biological treatment has been developed using the active sludge mixing process with MBBR. Turbo4bio was established as a sustainable and cost-effective solution for wastewater treatment plants in the early 1990s and ran on minimal sludge, and is easy to maintain. This
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The article considers the main reason for A. I. Herzen's address to obsolete words, which is their ability to acquire a stylistic coloring in the context of speech, as well as the possibility of combining, in some cases, with neutral lexemes of various functional styles. A certain stylistic effect of such characteristics of this type of vocabulary is represented, as a result of which their stylistic coloring in syntagmatic terms does not coincide with stylistic coloring in terms of paradigmatics, that is, in speech they have a completely stylistic meaning. Attention is focused on the role of outdated vocabulary, which consists in the fact that they serve to implement such features of the artistic style as imagery, emotionality, and their
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order to increase the level of security, as this system encrypts the secret image before sending it through the internet to the recipient (by the Blowfish method). As The Blowfish method is known for its efficient security; nevertheless, the encrypting time is long. In this research we try to apply the smoothing filter on the secret image which decreases its size and consequently the encrypting and decrypting time are decreased. The secret image is hidden after encrypting it into another image called the cover image, by the use of one of these two methods" Two-LSB" or" Hiding most bits in blue pixels". Eventually we compare the results of the two methods to determine which one is better to be used according to the PSNR measurs
Marriage outside the court is a manifestation of the oppression that women are subjected to in Iraq its seriousness comes out of the consequences that it leads to The. It overlooks the age of the girl and her marriage in younger age or coerced to marry as it leads to neglecting the affordability of marital relationship as long as the marriage does not have any legal or material consequences. The present study aims to detect Characteristics of both wives, husbands and families Who agree to marry her daughters outside the court. And the reasons that lead them to marry outside the courts. It also aims to provide information on the circumstances of marriage and reasons for refusing to ratify it in court. The study was based on the sample soc
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The Quranic discourse focused on a lot of vocabularies that carry goals that help man to acquire good, according to a methodology relies on adopting lofty ideas and values. The individual towards society, and the responsibility of society towards the individual. In our present age, the Muslim individual lives in a state of confrontation with deviant ideas, which unfortunately possess the means that make their impact great on society. The study concluded that the Holy Quran contains indicators and determinants of misguided and deviant thought, Which must be avoided because of the seriousness of its effects. Religion, in its general sense, represents a culture that transcends the limits of human ins
... Show MoreToday we are witnessing huge scientific and technical progress so we need more skills and methods of thinking that needs to be acquired by the teacher, as the importance of computers in education there are many teachers suffering of the difficulty in teaching for pupils . researchers tried to find a good suitable way with the technological interests for now which represent by computer design software and the introduction of enrichment activities in the curriculum because it is one of a contemporary trends for the development of the Arabic language with various levels of education and knowing if this program has negative or positive impact.
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... Show MoreObjective: to assess the awareness and knowledge of our medical students regarding dose levels of imaging procedures and radiation safety issues, and to conclude how the curriculum of clinical radiology in the college medical program impacts such knowledge.
Subjects and methods: this is a cross-sectional study conducted among 150 medical students in Alkindy College of Medicine between January 2021 to July 2021, regardless of their age or gender. The study included six grades according to the year 2020-2021. A questionnaire consisting of 12 multiple-choice questions was conducted via an online survey using Google Forms. The questions were divided into two parts
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Objective(s): To determine the impact of the Electronic Health Information Systems upon medical, medical backing and administrative business fields in Al-Kindy Teaching Hospital and to identify the relationship between such impact and their demographic characteristics of years of employment, place of work, and education. Methodology: A descriptive analytical design is employed through the period of April 25th 2016 to May 28th 2016. A purposive "non- probability" sample of (50) subject is selected. The sample is comprised of (25) medical and medical backing staff and (25) administrative staff who are all
Structure type and disorder have become important questions in catalyst design, with the most active catalysts often noted to be “disordered” or “amorphous” in nature. To quantify the effects of disorder and structure type systematically, a test set of manganese(III,IV) oxides was developed and their reactivity as oxidants and catalysts tested against three substrates: methylene blue, hydrogen peroxide, and water. We find that disorder destabilizes the materialsthermodynamically, making them stronger chemical oxidantsbut not necessarily better catalysts. For the disproportionation of H2O2 and the oxidative decomposition of methylene blue, MnOx-mediated direct oxidation competes with catalytically mediated oxidation, making the most
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The resort to the eloquence of the poetic image as a style reveals the poet's creativity and creativity in dealing with external influences, and reflect them with emotional images express a sense of intense emotional imagination, and this imagination stems from the experience of a poetic sense of truth, tasted by the recipient before the creator of the poetic text.