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.
Many of the signs that the global energy system indicate the start of a period of transition from total dependence on fossil energy sources, especially oil, into a new era in which alternative energy sources play an important role in meeting the growing needs of energy demand, so sought many of the developed countries through research the studies carried out to try to bring renewable energy sources and non-renewable (shale oil, oil sands, solar energy, wind energy .... etc) replace traditional fossil energy sources (oil, gas, coal) and despite the recent availability dramatically and spread throughout the the world, but they are going to dry up in the foreseeable future. So many countries, especially the developed sought to find
... Show MoreIn this paper, a compression system with high synthetic architect is introduced, it is based on wavelet transform, polynomial representation and quadtree coding. The bio-orthogonal (tap 9/7) wavelet transform is used to decompose the image signal, and 2D polynomial representation is utilized to prune the existing high scale variation of image signal. Quantization with quadtree coding are followed by shift coding are applied to compress the detail band and the residue part of approximation subband. The test results indicate that the introduced system is simple and fast and it leads to better compression gain in comparison with the case of using first order polynomial approximation.
Co-composting process can be acquired by combining organic fraction of municipal solid waste (OFMSW) with sewage sludge (SS) and mature compost (MC) as enhancement and bulking agent to overcome the problems of municipal solid waste and wastewater treatment plants besides the finally produced fertilizer usage for agriculture and horticulture. The effects of different mixture ratios of (OFMSW), (SS) and (MC) on the performance of composting process were investigated in this study. Piles of about 10 kg were prepared by mixing OFMSW, SS and MC in three different ratios (w/w) [OFMSW: SS: MC= 3:1:1, 3:2:1, and 3:3:1]. Results showed that the pile [3:1:1] was most beneficial to composting. The final compost products contained a
... Show MoreThe aim of the research is to assess the quality of the university accounting education system in Iraq. The researcher relied on the opinions of a sample of academics specialized in this field by preparing a checklist focusing on a set of axes that would affect the quality of accounting education in the Iraqi environment.
The most prominent finding of the research is that the quality of accounting education in Iraqi universities is medium and differs from one university to another in some quality components. In addition, the prescribed curricula and study plans applied in the accounting departments do not live up to the required level, as the largest proportion of those curricula are theoretically d
... Show MoreThis study discussed the effects of doping with silver (Ag) on the optical and structural properties of
CdO nanoparticles at different concentrations 0, 1, 2, 3, 4, 5 wt% prepared by the precipitation method. The
materials were annealed at 550˚C for 1 h. The structural, topographical, and optical properties were
diagnosed by X-ray diffraction analysis, atomic force instrument, and visible and ultraviolet spectrometers.
The results show that the average diameter of the grains depends on the percentage of added silver to the
material, as the diameter decreased from 88.8 to 59.7 nm, and it was found that the roughness increased from
5.56 to 26.5. When studying the optical properties, it was noted that th
الحمد الله أولا واخرا وبعد .. إن الواقع الذي عايشه الناس في ظل دولة المسلمين منذ إقامة دولة الإسلام بعد بعثة الرسول الكريم (صلى الله عليه وسلم ) في المدينة ولأكثر من أربعة عشر قرنا نرى إنه عاش في كنف هذه الدولة الكبيرة من بلاد الصين شرقا وإلى وسط أوربا وجنوب فرنسا غربا العشرات من الملل و الأديان والأجناس وممن لا يدينون بالإسلام وهم كما تحفظ لهم دولة الإسلام منهم وعيشهم الرغيد فهم يمارسون شعائرهم وطقوسهم الديني
... Show Moreيهدف البحث الحالي الى استكشاف علاقات التفاعل والتاثير بين الاحتكام للمكانة والتوجه للفردية– الجماعية والدمج التنظيمي مستنداً على مزج اختلاف القيم الشخصية مع افكار نظرية الهوية الاجتماعية لبلورة نموذج البحث. وفي ضوء هذا تم صياغة عدد من الفرضيات التي توضح علاقات التفاعل ما بين ابعاد الاحتكام للمكانة والتوجه للفردية– الجماعية للتنبؤ بوجود الدمج التنظيمي. جمعت البيانات باستخدام استمارة الاستبيان ووزع
... Show MoreThe idea of the design of combination Between split – plot and split block means that an experiment conducted with a design
formed by combination Between split – plot and split block, and it presents a precise manner to analytic who aimed to make appropriate statistical analysis for the experiment because such design contains four random errors , it make a high precision rather than another designs. The plan and the theoretical analysis were presented with application to show its idia and the ability to use it in many fields especially in agricultural experiments field .
Different frequency distributions models were fitted to the monthly data of raw water Turbidity at water treatment plants (WTPs) along Tigris River in Baghdad. Eight water treatment plants in Baghdad were selected, with raw water turbidity data for the period (2008-2014). The frequency distribution models used in this study are the Normal, Log-normal, Weibull, Exponential and two parameters Gamma type. The Kolmogorov-Smirnov test was used to evaluate the goodness of fit. The data for years (2008-2011) were used for building the models. The best fitted distributions were Log-Normal (LN) for Al-Karkh, Al-Wathbah, Al-Qadisiya, Al- Dawrah and, Al-Rashid WTPs. Gamma distribution fitted well for East Tigris and Al-Karamah WTPs. As for Al-
... Show MoreThe research aims to explain the References of receiving the explicit and implicit knowledge mentioned in the Noble Qur'an. The two researchers adopted the documentary and inductive approach to study the topic. Among the conclusions of the research: The Noble Qur'an dealt with many terms and concepts that refer to the References of making explicit knowledge available, including books, which were represented by the divine books (the Qur'an, the Torah, the Zabur and the Gospel) and their concepts (the book, the Qur'an, the guidance, the remembrance, the revelation, the light, the newspapers, the plates). He dealt with many concepts that refer to the References of providing tacit knowledge, which was represented by the communication between tw
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