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 aim of this study was to provide an overall assessment to the efficiency of the Iraq stocks exchanges (ISE) through specifying well –known models .First, Fama's efficient market hypothesis as a contrary concept to the random walk hypothesis, was performed and it has been found that ISE follows the random process, so the price of the shares can't be predicated on the basis of past information. Second,we use a multifactor model, which so named multiple regression, to explore the link between ISE and the main economic indicators. our empirical analysis finds that every weak associations exists between major ISE measures and main economic indicators.
Implementation of Warm Mix Asphalt concrete (WMA) is getting global acceptance due to the restrictions for protecting the environment and the requirements to reduce fuel consumption. In this investigation, two WMA mixtures have been prepared in the laboratory using medium curing cutback (MC-30) and Cationic emulsion asphalt. Hot Mix Asphalt (HMA) was also prepared for comparison. The cylinder specimens (63.5mm) in height and (101.6mm) in diameter were constructed from the mixtures and subjected to indirect tensile strength test to determine the Tensile Strength Ratio (TSR). The cylinder specimens of (101.6mm) in height and (101.6mm) in diameter were also constructed from those mixtures and subjected to static compressive
... Show MoreSelf- curing is the potential of lightweight aggregate to absorption great amount of water thru mixing which prominently can moves to the paste during hydration process. Self- curing empowers a water to be distributes more evenly act out the cross section. Whereas, the external curing water is only able to penetrate several millimetres into concrete with low water cement ratio. Brick dust accumulates in the demolish site creates serious environmental contamination. This study investigates the effect of brick dust recovered from construction site on the Properties of mortar cured in three curing conditions. Mortar in this study produced using BD as cement additive with (2, 4, 6, and 8) % by weight of cement. BD was used a
... Show MoreObjective(s): To evaluate the family physicians' practices and to measure its impact upon the quality of family
medicine health care in Baghdad City model primary health care centers.
Methodology: A descriptive study, using the evaluation approach, has evaluated the impact of family physicians'
practices upon quality of healthcare in Baghdad's Model Primary Health Care Centers of Family Medicine. It is
carried out during 15th of May – 20th of August 2017. The study is conducted at five model primary health care
centers of family medicine from two districts; AL-Rusafa and AL-Kurkh. Sample size is calculated to be (76)
family physicians. Convenient sample of (124) patients who are attending these primary health care cen
Soft clays are generally sediments deposited by rivers, seas, or lakes. These soils are fine-grained plastic soils with appreciable clay content and are characterized by high compressibility and low shear strength. To deal with soft soil problems there is more than one method that can be used such as soil replacement, preloading, stone column, sand drains, lime stabilization and Prefabricated Vertical Drains, PVDs. A numerical modeling of PVD with vacuum pressure was analyzed to investigate the effect of this technique on the consolidation behavior of fully and different depths of partially saturated soft soils. Laboratory experiments were also conducted by using a specially-designed large consol
... Show MorePalm vein recognition is a one of the most efficient biometric technologies, each individual can be identified through its veins unique characteristics, palm vein acquisition techniques is either contact based or contactless based, as the individual's hand contact or not the peg of the palm imaging device, the needs a contactless palm vein system in modern applications rise tow problems, the pose variations (rotation, scaling and translation transformations) since the imaging device cannot aligned correctly with the surface of the palm, and a delay of matching process especially for large systems, trying to solve these problems. This paper proposed a pose invariant identification system for contactless palm vein which include three main
... Show MoreThe status of women in any society is one of the basic criteria for measuring the degree of progress that society and follow renaissance march side by sidewith men , and is no doubt that women are now of interest to the state , even if limited , which promotes public ideologies on the need for womens participation in economic infrastructure operations and social and the right to gain information and knowledge, entertainment and exercise its role in development through its president and actor in the family and raising the next generation configuration.
And affect the basic tributaries that draws them women information and ideas have a direct impact on the composition of cultural and cognitive entity woman comes satellite channels
... Show MoreThe research deals with a very important topic, which is social security viewed in the context of criminal protection for state security and the challenges it faces after a decisive change in the methods of war. The research also presents a different division of the generations of wars. We limit ourselves to four of them based on the change in the strategic war objectives and not just the means of committing them. This is because these means are not suitable for describing the real changes in the patterns of wars and the goals that it seeks to achieve. The research stresses the importance of putting the concept of state security in its correct framework, which is part of social security, so that the interest of the political system and the
... Show MoreThis study aimed to identify the extent of teachers' application of professional standards from the point of view of supervisors and detecting differences in the means of their estimates that may be attributed to the variables of the study (sex, number of years of service, educational qualification).The study adopted a descriptive approach. In order to achieve the aims of the study, a questionnaire including four areas, namely: (professional features, academic knowledge and pedagogy, teaching and learning, and professional development) was constructed.
The questionnaire was applied to a population which consisted of 60 supervisors of all school subjects in the Directorates of Education in
... Show MoreAbstract
In the present study, composites were prepared by Hand lay-up molding. The composites constituents were epoxy resin as a matrix, 6% volume fractions of glass fibers (G.F) as reinforcement and 3%, 6% volume fractions of preparation natural material (Rice Husk Ash, Carrot Powder, and Sawdust) as filler. Studied the erosion wear behavior and coating by natural wastes (Rice Husk Ash) with epoxy resin after erosion. The results showed the non – reinforced epoxy have lower resistance erosion than natural based material composites and the specimen (Epoxy+6%glass fiber+6%RHA) has higher resistance erosion than composites reinforced with carrot powder and sawdust at 30cm , angle 60
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