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 study, a 3 mm thickness 7075-T6 aluminium alloy sheet was used in the friction stir welding process. Using the design of experiment to reduce the number of experiments and to obtain the optimum friction stir welding parameters by utilizing Taguchi technique based on the ultimate tensile test results. Orthogonal array of L9 (33) was used based on three numbers of the parameters and three levels for each parameter, where shoulder-workpiece interference depth (0.20, 0.25, and 0.3) mm, pin geometry (cylindrical thread flat end, cylindrical thread with 3 flat round end, cylindrical thread round end), and thread pitch (0.8, 1, and 1.2) mm) this technique executed by Minitab 17 software. The results showed th
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There is an increase in the need for cost accounting in all organizations and from different sectors to provide detailed information to the totals of financial accounting, first and help solve problems associated with inventory and analysis, tabulation and allocation of cost elements II and do the planning process and provide the necessary oversight and help to take the right decisions such as pricing decisions that need to Information cost accounting.
And suffer most of the non-governmental organizations from the lack of a cost accounting system provides information on the cost of service in these organizations and the department research sample circle v
This research sheds light on the morphological structure of nouns and verbs in the novel "ASTONISHMENT" by the novelist Aharon Applefield by analysing selected models from the novel in a morphological analysis in order to identify the most important morphological features of this structure according to a statistical analytical approach.
The morphological structure is the main pillar of the linguistic structure of the literary text. Morphology is the science that studies the word, by which its structure and original letters are known, and the change that has occurred to it. The aesthetics of the fictional text is reflected in this structure, through which the writer conveys his ideas and narrations to the reader. The research
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The problem of generated waste as a result of the implementation of construction projects, has been aggravated recently because of construction activity experienced by the world, especially Iraq, which is going through a period of reconstruction, where construction waste represents (20-40%) of the total generated waste and has a negative effect on the environment and economic side of the project. In addition, the rate of consumpted amounts of natural resources are estimated to be about 40% in the construction industry, so it became necessary to reduce waste and to be manage well. This study aims to identify the key factors affecting waste management through the various phases of the project, and this is accom
... Show MoreThe research aims to identify the level of educational supervisors' practices of their supervisory duties according to the requirements of comprehensive quality from the viewpoint of teachers in Oman. Moreover, identify the differences between the responses of the sample about these practices, which are attributed to gender, and years of experience. Thus, a questionnaire was administered to teachers, consisting of (48) items distributed on (5) main fields related to the educational supervisor's practices. The sample consisted of (220) teachers who were randomly chosen from the schools in Dhofar region. Data were analyzed using means, standard divisions, T-test, and One Way ANOVA. The research concluded that the level of educational super
... Show MoreBackground: Disc battery ingestion is a common
serious problem in Iraq. It increase in the last years
because of the increase in number of electronic toys
that uses these batteries. These batteries contains
many types of irritant chemicals that increases the
risk of it's ingestion.
Methods:We reviewed the medical records of
children aged between 1year and 7 years
old admitted to Surgical Specialty Hospital/Baghdad
Medical City due to disc battery ingestion from
January 2007 through December 2010). The diagnosis
of disc battery ingestion was based upon history,
clinical symptoms, and results of imaging studies.
The clinical data reviewed included sex, age, clinical
manifestation and duration of sy
Thin films of pure polycarbonate (PC) with anthracene doping PC films for different doping ratios (10, 20, 30, 40, 50 and 60 ml) were prepared by using a casting method. The influence of anthracene doping ratio on photo-fries rearrangement of polycarbonate was systematic investigated. Furthermore, pure PC and anthracene doping PC films were irradiated via UV light at a wavelength (254 nm) for different periods (5, 240, 288, and 360 hrs). The photo-fries rearrangement occurring in pure PC and anthracene doping PC films were monitored using UV and FTIR spectroscopies. The photo-fries rearrangement leads to scission the carbonate linkage and formation phenylsalicylate and dihydroxybenzophenes. The result of the UV spectrum confirms disappea
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The article examines metaphors as one of the fundamental means used by D. Rubina when writing the novel “Parsley Syndrome” to form images of dolls as equal heroes of the work. The author of the article continues research related to the work of Dina Ilinichna Rubina, a representative of modern Russian prose.
In this paper the method of singular value decomposition is used to estimate the ridge parameter of ridge regression estimator which is an alternative to ordinary least squares estimator when the general linear regression model suffer from near multicollinearity.
An investigation was conducted effect of addition co- solvent on solvent extraction process for two types of a lubricating oil fraction (spindle) and (SAE-30) obtained from vacuum distillation unit of lube oil plant of Daura Refinery. In this study two types of co-solvents ( formamide and N-methyl, 2, pyrrolidone) were blended with furfural to extract aromatic hydrocarbons which are the undesirable materials in raw lubricating oil, in order to improve the viscosity index, viscosity and yield of produced lubricating oil. The studied operating condition are extraction temperature range from 70 to 110 °C for formamide and 80 to 120 °C for N-methyl, 2, pyrrolidone, solvent to oil ratio range from 1:1 to 2:1 (wt./wt.) for furfural with form
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