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.
Desulfurization of a simulated diesel fuel by different adsorbents was studied in a fixed-bed adsorption process operated at ambient temperature and pressure. Three different adsorption beds were used, commercial activated carbon, Cu-Y zeolite, and layered bed of 15wt% activated carbon followed by Cu-Y zeolite.Initially Y-zeolite was prepared from Iraqi rice husk and then impregnated with copper. In general, the adsorbents tested for total sulfur adsorption capacity at break through followed the order Ac/Cu-Y zeolite>Cu-Y zeolite>Ac. The best adsorbent, Ac/Cu-Y zeolite is capable of producing more than 30 cm3 of simulated diesel fuel per gram of adsorbent with a weighted average content of 5 ppm-S, while Cu-Y zeolite producing of
... Show MoreAbstract
This study aims to identify the reality of using electronic applications in teaching language skills to people with mild intellectual disabilities from the mothers’ perspective. A descriptive approach was used. The electronic questionnaires were administered to the study sample, 122 responses were received from mothers of the students with mild intellectual disability in Hafer Al-Baten schools. The response average rate was 94%. The results showed that there are statistically significant differences that are related to the variant of monthly income as for the barriers to using electronic applications in such schools, whereas there were no differences regarding the variant of monthly income regarding t
... Show More
In this work, the modified Lyapunov-Schmidt reduction is used to find a nonlinear Ritz approximation of Fredholm functional defined by the nonhomogeneous Camassa-Holm equation and Benjamin-Bona-Mahony. We introduced the modified Lyapunov-Schmidt reduction for nonhomogeneous problems when the dimension of the null space is equal to two. The nonlinear Ritz approximation for the nonhomogeneous Camassa-Holm equation has been found as a function of codimension twenty-four.
The Purpose of this Research show gap between a Normal Cost System and Resource consumption Accounting Applied in AL-Rafidin Bank.
The Research explores that, how the idle capacity can be determined under resource consumption accounting, discuss the possibility of employing these energies. Research also viewed how costs can be separated into Committee and Attribute. Resource Consumption Accounting assists managers in pricing services or products based on what these services or products use from each Source.
This Research has been proven
Abstract Infinitives and gerunds are non-finite verb forms which cannot be indicated by tense, number, or person. The construction of non-finite verbs is intricate because of their nature of meanings, forms, and functions. The major problem is that both infinitival and gerundial complements have identical functions and occupy identical positions in the sentences. Thus, there is a confusion in using an infinitival and gerundial forms after aspectual verbs. The selection of either one of these two forms as complements is controlled syntactically or semantically. Moreover, both forms can be used usually with similar predicate but with neat difference in meaning. In addition, there are problems with controlling the use of aspect, since aspectua
... Show MoreThe reason behind choosing this topic " internal marketing (IM) of human resource management (HRM)" is to highlight the advantages of using IM in the organization framework. The problem of the research paper lies in not paying enough attention to employees genuine needs as they interact with each other in the sake of organization prosper. This research paper can be used as indictor to expose the weaknesses that the organization encounters daily. The current research paper attempts at examining the possibility of developing philosophy of internal marketing of human resources and its most practices, empowering staff, training courses, motivations and recognitions, and within departments communication, in order to reach targeted res
... Show MoreA model using the artificial neural networks and genetic algorithm technique is developed for obtaining optimum dimensions of the foundation length and protections of small hydraulic structures. The procedure involves optimizing an objective function comprising a weighted summation of the state variables. The decision variables considered in the optimization are the upstream and downstream cutoffs lengths and their angles of inclination, the foundation length, and the length of the downstream soil protection. These were obtained for a given maximum difference in head, depth of impervious layer and degree of anisotropy. The optimization carried out is subjected to constraints that ensure a safe structure aga
... Show MoreIn this work; copper oxide films (CuO) were fabricated by PLD. The films were analyzed by UV-VIS absorption spectra and their thickness by using profilometer. Pulsed Nd:YAG laser was used for prepared CuO thin films under O2 gas environment with varying both pulse energy and annealing temperature. The optical properties of as-grown film such as optical transmittance spectrum, refractive index and energy gap has been measured experimentally and the effects of laser pulse energy and annealing temperature on it were studied. An inverse relationship between energy gap and both annealing temperature and pulse energy was observed.
This paper studied the behaviour of reinforced reactive powder concrete (RPC) two-way slabs under static load. The experimental program included testing three simply supported slabs of 1000 mm length, 1000 mm width, and 70 mm thickness. Tested specimens were of identical properties except their steel fibers volume ratio (0.5 %, 1 %, and 1.5 %). Static test results revealed that, increasing steel fibers volume ratio from 0.5% to 1% and from 1% to 1.5%, led to an increase in: first crack load by (32.2 % and 52.3 %), ultimate load by (36.1 % and 17.0 %), ultimate deflection by (33.6 % and 3.4 %), absorbed energy by (128 % and 20.2 %), and the ultimate strain by (1.1 % and 6.73 %). The stiffness and ductility of the specimens also increased. A
... Show MoreThe study presents the test results of Completely Decomposed Granite (CDG) soil tested under drained triaxial compression, direct shear and simple shear tests. Special attention was focused on the modification of the upper halve of conventional Direct Shear Test (DST) to behave as free
head in movement along with vertical strain control during shear stage by using Geotechnical Digital System (GDS). The results show that Free Direct Shear Test (FDST) has clear effect on the measured shear stress and vertical strain during the test. It has been found that shear strength
parameters measured from FDST were closer to those measured from simple shear and drained triaxial compression test. This study also provides an independent check on