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.
Soft clays are generally characterized by low shear strength, low permeability and high compressibility. An effective method to accelerate consolidation of such soils is to use vertical drains along with vacuum preloading to encourage radial flow of water. In this research numerical modeling of prefabricated vertical drains with vacuum pressure was done to investigate the effect of using vertical drains together with vacuum pressure on the degree of saturation of fully and saturated-unsaturated soft soils. Laboratory experiments were conducted by using a specially-designed large consolidometer cell where a central drain was installed and vacuum pressure was applied. All tests were conducted
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The current research aims to identify the level of organizational relaxation among the employees of educational directorates in the Sultanate of Oman. The descriptive approach was used, as well as a questionnaire of two parts to collect data. The questionnaire consists of (15) items divided into three themes about the relaxing level. It was applied on a sample of (406) male & female employees of the educational directorates who were randomly selected. The results of the study showed that the level of organizational relaxation was low. The study results also found that there were no statistically significant differences at the level of significance (α ≤ 0.05) of the study sample in the level of org
... Show MoreThe current research aims to identify the level of extension of the sense of self and the cognitive style (complexity - simplification) among university students, as well as the significance of the difference according to gender (males - females), as well as the correlation between the two variables, and in order to verify this, the researcher has constructed The measure of the extension of the sense of self based on the theory of Alport 1961, as the number of its final paragraphs reached (28) paragraphs, and the cognitive style scale (complexity - simplification) prepared by (Abdullah 2017) was adopted, as the scale consisted of (32) paragraphs in its final form. To verify their psychometric properties, and the two tools were applied to
... Show MoreThis study seeks to address the impact of marketing knowledge dimensions (product, price, promotion, distribution) on the organizational performance in relation to a number of variables which are (efficiency, effectiveness, market share, customer satisfaction), and seeks to reveal the role of marketing knowledge in organizational performance.
In order to achieve the objective of the study the researcher has adopted a hypothetical model that reflects the logical relationships between the variables of the study. In order to reveal the nature of these relationships, several hypotheses have been presented as tentative solutions and this study seeks to verify the validity of these hypotheses.
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The basic skills (defensive & offensive) in basketball it is a base for completion and decide the level of the team and the rank, in same time considers the axel of the researchers when putting tests and forming new groups so close from real situation games to create real vision and estimate for skill state and a method to recorrect & presenting positive resolutions, the problem of research were indicate to variables may happen in training operation it demand tests matches with these variables and forming new standards, and another way the researchers find a few patterns for measuring basic skills (defensive & offensive) also application these tests on samples it differs from the originals one that the tests designed for it. The sample repr
... Show MoreNew metal complexes of some transition metal ions Co(II), Cu(II) , Cd(II) and Zn(II) were prepared by their reaction with previously prepared ligands HLI= (P-methyl anilino) phenyl acetonitrile and HLII = (P-methyl anilino) –P– chloro phenyl acetonitrile . The two ligands were prepared by Strecker’s procedure which includ the reaction of p- toluidine with benzaldehyde and P- chlorobenzaldehyde respectively. Structures were proposed depending on atomic absorption , i.r. and u.v.visible spectra in addition to magnetic susceptibility and electrical conductivity measurements.
The transport of energy from the focal region when high power laser are focused onto
solid targets is of two dimensions axially in the direction of the laser and laterally in the
direction along the target surface perpendicular to the laser direction.
In this paper we present anew consideration to study lateral energy transport in plasma
produced by laser KrF λ=248nm and pulse time 20n sec. Targets are C, Al, Cu.we used
photo resist (negative type) which is mode localy and noticing the effective area as
afunction of lateralenergy transport
The present study aims at knowing the effect of instrumental enrichment in the acquisition of geographical concepts for first grade student in intermediate school. The study is restricted in the students of first grade student in intermediate school\ The EducationalDirectorate of Rusafa for academic (2013/2014),for the purpose of achieving the objective, the following hypotheses:
There is no statistical significant different at the level of (0.5) between the scores of the experimental group who study geography according to the instrumental enrichment and the scores of the control group who learned geographical according to the traditional methods.
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... Show MoreObjectives: The current study aims at identifying the level of perceived stress among nursing college students and determining the factors associated with stress they have. Methodology: A cross-sectional descriptive study initiated for the period on November 1st, 2014 to May 1st, 2015. The study has been conducted on the undergraduate nursing college students / University of Baghdad. The sample of the study was consisted of (128) students who were selected purposively. The questionnaire of the study was adopted and modified for the present study which consisted of socio-demographic data and the scale of
The research aims to apply one of the techniques of management accounting, which is the Quality Function Deployment(QFD) on the Pepsi product in Baghdad Soft Drinks Company and to determine the technical requirements objectively that have been applied in practice in Baghdad Soft Drinks Company / a private shareholding company, as it focuses on meeting the quality requirements and achieving positive quality to provide a product It meets the requirements of current and future customers, hence the importance of research that indicates that the Quality Function Deployment(QFD) is a useful tool to develop the requirements of new products, being a design process driven by customers through their voices, and thus contribute to achieve a competi
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