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.
Low bearing capacity of weak soil under shallow footings represents one of construction problems.
Kaolin with water content converges to liquid limit used to represent the weak soil under shallow
footing prototype. On the other hand, fly ash, which can be defined as undesirable industrial waste
material, was used to improve the bearing capacity of the soft soil considered in this research. The soft
soil was prepared in steel box (36×36×25) cm and shallow square footing prototype (6×6) cm were
used .Group of physical and chemical tests were conducted on kaolin and fly ash. The soft soil was
improved by a bed of compacted fly ash placed under the footing with dimensions equal to that of
footing but with different de
Receipt date:3/13/2021 accepted date:5/26/2021 Publication date:12/31/2021
This work is licensed under a Creative Commons Attribution 4.0 International License.
energy is one of the strategic resources within international politics, and this is through the existing competition between the international powers on it, and the global powers have begun to rely on interest in new areas, such as import, depending on new projects an
... Show MoreEfficient cuttings transport and hole cleaning are very important factors for obtaining an effective drilling operation. In an inclined and horizontal drilling, hole cleaning issue is a common and complex problem.
The scope of this research is to study the drilling parameters which affect hole cleaning in Iraqi directional wells through studying and analyzing some drilled wells ( vertical , directional (30 degree) , directional (60 degree) and horizontal ).An excel sheet is prepared to calculate carrying capacity index which represents an indicator for good hole cleaning in different sections. The study indicated through the field investigations, practical experiences and theoretical calculations tha
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Faces of the individual in his life many stressful events, which includes expertise undesirable, and events may involve a lot of sources of tension and the risk factors and threats in all areas of life, and this would make the stressful events play a role in the genesis of many diseases physical.
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The aim of the current research is to identify the level of organizational culture among the headmasters and teachers of intermediate and secondary schools in Arar city. It also aims to identify the effect of job variables, qualifications, educational stage, and years of experience on the level of organizational culture and its domains. The research sample consisted of 62 participants divided into 7 headmasters and 55 teachers. The researcher used the questionnaire of the organizational culture. The researcher used also statistical methods such as mean, standard deviation, t-test, and One way ANOVA. The results revealed that the level of organizational culture and its four domains were high, and there was no effect of the variables (teac
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