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 surgeryKeywords: Non-surgical treatment of anal fissure, fissure in ano, sphicterotomy,botulinum toxin in anal fissures, glyceryl trinitrate. Chemical sphincteratomy, pharmacological sphincteratomy.
Zernike Moments has been popularly used in many shape-based image retrieval studies due to its powerful shape representation. However its strength and weaknesses have not been clearly highlighted in the previous studies. Thus, its powerful shape representation could not be fully utilized. In this paper, a method to fully capture the shape representation properties of Zernike Moments is implemented and tested on a single object for binary and grey level images. The proposed method works by determining the boundary of the shape object and then resizing the object shape to the boundary of the image. Three case studies were made. Case 1 is the Zernike Moments implementation on the original shape object image. In Case 2, the centroid of the s
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Objective: An efficient solution for stabilization is the mobilization of the joints for the arthrokinematics affected by the positional defect of the CAI (i.e. chronic ankle instability). This study put to comparison the impacts of ankle dorsi flexion range of motion (DFROM) as well as dynamic balance ability (DBA) in the patients who have CAI using PJM (i.e. passive joint mobilization), a technique typically been used in previous works, and active joint mobilization (AJM), a technique which could have a greater impact on cortical excitability with the spontaneous movement. Design: rehabilitation program to treat recurrent ankle. Methods: A total of 10 players from the Iraqi clubs Muay Thai team were registered, 5 from each of
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In this research work, a new type of concrete based on sulfur-melamine modification was introduced, and its various properties were studied. This new type of concrete was prepared based on the sulfur-melamine modification and various ingredients. The new sulfur-melamine modifier was fabricated, and its fabrication was confirmed by IR spectroscopy and TG analysis. The surface morphology resulted from this modifier was studied by SEM and EDS analysis. The components ratios in concrete, chemical and physical characteristics resulted from sulfur-melamine modifier, chemical and corrosion resistance of concrete, stability of concrete against water adsorption, stability of concrete against freezing, physical and mechanical properties and durabi
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Our goal in the present paper is to recall the concept of general fuzzy normed space and its basic properties in order to define the adjoint operator of a general fuzzy bounded operator from a general fuzzy normed space V into another general fuzzy normed space U. After that basic properties of the adjoint operator were proved then the definition of fuzzy reflexive general fuzzy normed space was introduced in order to prove that every finite dimensional general fuzzy normed space is fuzzy reflexive.
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War as a human phenomenon, has its own literature. Poetry is a major genre in this literature. This paper is an attempt to investigate and analyse some stylistic features in two selected, English and Arabic, war poems. These poems share the same theme.Both promote the principle of sacrificing one’s own life for the sake of homeland. This paper limits itself to analyse, thecontent words, tenses, semantic grouping of vocabulary and foregrounding in the two poems. The areas of analysis show great similarities in distributing the general content words (nouns, verbs, adjectives, and adverbs). In the analysis of the semantic areas of each content word, these poems reveal some similarities and some differences in their frequency rates.
... Show MoreIn this study, we introduce new a nanocomposite of functionalize graphene oxide FGO and functionalize multi wall carbon nanotube (F-MWCNT-FGO).The formation of nanocomposite was confirmed by FT-IR ,XRD and SEM. The magnitude of the dielectric permittivity of the (F-MWCNT-FGO) nanocomposite appears to be very high in the low frequency range and show a unique negative permittivity at frequencies range from 400 Hz to 4000Hz. The ac conductivity of nanocomposite reaches 23.8 S.m-1 at 100Hz.
In this work, an experimental analysis is made to predict the thermal performance of the natural-convection phenomenon from a heated vertical externally finned-tube to surrounding air through an open-ended enclosure. Two different configurations of longitudinal rectangular fin namely, continuous and interrupted are utilized with constant thickness, different numbers, and different heights are extended radially on the outer surface of a heated tube. The tube is heated electrically from inner surface with five varied power input magnitudes. The effect of fins configuration, fins number, fins height, and heat flux of the inner tube surface on the thermal performance of natural c
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Find cares studying ways in the development of industrial products and designs: the way the progressive development (how typical) and root development (jump design), was the aim of the research: to determine the effectiveness of the pattern and the jump in the development of designs and industrial products. After a process of analysis of a sample of research and two models of contemporary household electrical appliances, it was reached a set of findings and conclusions including:1-leaping designs changed a lot of entrenched perceptions of the user on how the product works and its use and the size and shape of the product, revealing him about the possibilities of sophisticated relationships with the product, while keeping the typical desi
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Aims: The present study aims at assessing mothers’ knowledge of breastfeeding in Kirkuk governorate,
besides determining the relationship between mothers’ knowledge and some of their demographic
attributes.
Methodolgy: A descriptive study was used the assessment approach and applied on mothers in Kirkuk
governorate from January 15th 2011 to July 25th
, 2011. Non-probability sampling a convenience sample of
(72) mothers, attending pediatric general hospital in Kirkuk governorate for following up the health status
of their children, was selected for the purpose of the study. A questionnaire was developed for the
purpose of the study. It was comprised of two parts; the first part includes the mothers' demographic