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.
Direct contact membrane distillation is an effective method for production of fresh water from saline water. In this study two samples were used as feed solutions; the first one was RO waste from Al-Hilla Coca-Cola Factory (TDS= 2382 mg/l) and the other was Haji Ali drainage water (TDS= 4127 mg/l). Polytetrafluoroethylene (PTFE) hydrophobic membrane supported with polypropylene (PP) was used as flat sheet form with plate and frame cell. Results proved that membrane distillation is an effective technique to produce fresh water with high quality from brine with low salinity content. With membrane area of 8x8 cm2, the volume of treated water decreased from 34.97 ml at first half hour to 33.02 ml after 180 min of
... Show MoreThis research aims to measure the productivity of nursing services and recognize the reality of providing such services in some public hospitals in the province of Diyala, as well as identify the most important factors affecting the productivity of nursing services, and developer measure adopted by the researcher (Kien, 2012), which includes seven factors (workforce , management team, stimulation, pressure of working hours (time), material / equipment, supervision, safety), Used the experimental method in the search, one of the private scientific research curriculum depends primarily on the scientific experiment and study of the subject, or a scientific phenomenon, which provides an opportunity to learn the facts
... Show MoreThe current research aims to evaluate the activities and evaluation questions implied in the content of the computer textbook for the fifth preparatory grade according to the creative thinking and developing suggestions through answering the following question: what is the percentage of creative thinking skills in the content of the computer textbook for the fifth Preparatory grade students issued by the Iraqi Ministry of Education/ Directorate General of the curriculum in the academic year (2019-2020)? The researchers followed the descriptive-analytical approach. The research community was determined by the content of the computer textbook for the fifth preparatory grade. As for the research sample, it was limited to all activitie
... Show MoreThe current study aims to identify the feeling of job alienation and organizational commitment among free lecturers in secondary schools, as well as to identify the significance of the differences in the feeling of job alienation according to the gender and the significance of the differences in organizational commitment according to the gender. It also aims to identify the correlation between the feeling of job alienation and organizational commitment. To achieve the objectives of the research, the researcher developed two scales: one consisted of (24) items to measure the vacancy in job alienation and the other consisted of (24) items to measure the organizational commitment. The two tools were applied to a sample of (200) male and fem
... Show MoreThe aim of this research is to identify the level of mental mindfulness among female students of the College of Education at Umm Al-Qura University, as well as to identify the statistically significant differences in the level of mental mindfulness according to academic level, specialization, and academic achievement. A mental mindfulness scale was designed to cover five dimensions. The study employed the analytic descriptive approach applied to a random sample of (217) female students from various academic specializations. The findings indicated that the level of mental mindfulness was average among female students. Statistically significant differences were attributable to the academic level, academic specializations, and academic achi
... Show MoreThere many methods for estimation of permeability. In this Paper, permeability has been estimated by two methods. The conventional and modified methods are used to calculate flow zone indicator (FZI). The hydraulic flow unit (HU) was identified by FZI technique. This technique is effective in predicting the permeability in un-cored intervals/wells. HU is related with FZI and rock quality index (RQI). All available cores from 7 wells (Su -4, Su -5, Su -7, Su -8, Su -9, Su -12, and Su -14) were used to be database for HU classification. The plot of probability cumulative of FZI is used. The plot of core-derived probability FZI for both modified and conventional method which indicates 4 Hu (A, B, C and D) for Nahr Umr forma
... Show MoreANN modeling is used here to predict missing monthly precipitation data in one station of the eight weather stations network in Sulaimani Governorate. Eight models were developed, one for each station as for prediction. The accuracy of prediction obtain is excellent with correlation coefficients between the predicted and the measured values of monthly precipitation ranged from (90% to 97.2%). The eight ANN models are found after many trials for each station and those with the highest correlation coefficient were selected. All the ANN models are found to have a hyperbolic tangent and identity activation functions for the hidden and output layers respectively, with learning rate of (0.4) and momentum term of (0.9), but with different data
... Show MoreIn this paper waste natural material (date seed) and polymer particles(UF) were used for investigation of removal dye of the potassium permanganate. Also study effect some variables such as pH, dye concentration and adsorbent concentration on dye removal. 15 experimental runs were done using the itemized conditions designed established on the Box-Wilson design employed to optimize dye removal. The optimum conditions for the dye removal were found: (pH) 12, (dye con.) 2.38 ppm, (adsorbant con.) 0.0816 gm for date seed with 95.22% removal and for UF (pH) 12, (dye con.) 18 ppm, (adsorbant con.) 0.2235 gm with 91.43%. The value of R-square was 85.47% for Date seed and (88.77%) for UF.
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A New Spectrophotometric Methods are improved for determination Metronidazole (MTZ) and Metronidazolebenzoate (MTZB) depending on1STand 2nd derivative spectrum of the two drugs by using ethanol as a solvent. Many techniques were proportionated with concentration (peak high to base line, peak to peak and peak area). The linearity of the methodsranged between(1-25µg.ml-1) is obtained. The results were precise and accurate throw RSD% were between (0.041-0.751%) and (0.0331-0.452%), Rec% values between (97.78, 101.87%) and (98.033-102.39%) while the LOD between (0.051-0.231 µg.ml-1) and (0.074-1.04 µg.ml-1) and LOQ between (0.170-0.770µg.ml-1) and (0.074-0.313 µg.ml-1) of (MTZ) and of (MTZB) respectively. These Methods were successfully ap
... Show MoreA character is one of the most important pillars of narrative production. Most critics believe that a character is the focus of events.
Jacob Steinberg, a Jewish writer who is Ukrainian by origin, wrote many stories, most of which spoke about the lives of Jews in the diaspora, especially in Ukraine. The environment there has been reflected in his stories.
Steinberg focused on the role of characters in shaping these productions.
In this study, we discuss the conflict of characters in Steinberg's stories. This conflict is characterized by different trends and goals. There is a conflict with the environment, a conflict with society, a conflict with the self,
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