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.
A simulation study is used to examine the robustness of some estimators on a multiple linear regression model with problems of multicollinearity and non-normal errors, the Ordinary least Squares (LS) ,Ridge Regression, Ridge Least Absolute Value (RLAV), Weighted Ridge (WRID), MM and a robust ridge regression estimator MM estimator, which denoted as RMM this is the modification of the Ridge regression by incorporating robust MM estimator . finialy, we show that RMM is the best among the other estimators
This paper discusses the Sums of Squares of “m” consecutive Woodall Numbers. These discussions are made from the definition of Woodall numbers. Also learn the comparability of Woodall numbers and other special numbers. An attempt to communicate the formula for the sums of squares of ‘m’ Woodall numbers and its matrix form are discussed. Further, this study expresses some more correlations between Woodall numbers and other special numbers.
Many tools and techniques have been recently adopted to develop construction materials that are less harmful and friendlier to the environment. New products can be achieved through the recycling of waste material. Thus, this study aims to use recycled glass bottles as sustainable materials.
Our challenge is to use nano glass powder by the addition or replacement of the weight of the cement for producing concrete with enhanced strength.
A nano recycled glass p
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Rhythm is considered one of the creative concepts in the recent architectural thought; it has emerged clearly as a mean of creating the highest levels of creativity in architecture, especially in contemporary architectural movements. The importance of rhythm has emerged, especially, when the architecture , its beginnings concentrated on the principle of the links with poetic structures. Many architectural studies deal with concept of rhythm in architecture with different ways various according to the trend of each study, this show the importance of studying the concept of rhythm in the architectural field in general. This study try to focus on the utilization of rhythm as creative system in architecture of heritage and contemporary
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Soil stabilization with stone powder is a good solution for the construction of subgrade for road way and railway lines, especially under the platforms and mostly in transition zones between embankments and rigid structures, where the mechanical properties of supporting soils are very influential. Stone powder often has a unique composition which justifies the need for research to study the feasibility of using this stone powder type for ground improvement applications. This paper presents results from a comprehensive laboratory study carried out to investigate the feasibility of using stone powder for improvement of engineering properties of clays.
The stone powder contains bassanite (CaSO4. ½ H
... Show MoreThe use of destructive weapons in wars without restrictions and controls, which eat green and dry land, pollute the environment and cause genocide, has become the problem of the times.
International conventions for the protection of the environment during armed conflicts are characterized by generality, ambiguity, and open to interpretation by the participating states in the agreement, and each state interprets these texts to serve its interests, but the Islamic Sharia stipulates the prohibition of the use of these comprehensive destructive weapons in an unambiguous manner, As stated in the Holy Quran:
... Show MoreThe research aims to apply one of the techniques of management accounting, which is the technique of the quality function deployment on the men's leather shoe product Model (79043) in the General Company for Textile and Leather Industries by determining the basic requirements of the customer and then designing the characteristics and specifications of the product according to the preferences of the customer in order to respond to the customer's voice in agreement With the characteristics and technical characteristics of the product, taking into account the products of the competing companies to achieve the maximum customer satisfaction, the highest quality and the lowest costs. Hence, the importance of research has emerged, which indicat
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Man was closely associated with nature in its various forms, as it represented the incubator for him in all areas of his life, so writers often made it a material for their literature and a fertile ground for their productions, so it appeared in its various forms and man’s need for it, its good and its bad in literature throughout history, and the Arabs are like Other nations, since the pre-Islamic era, nature was an important outlet and a refuge for poets in the production and creativity of literature and to this day, and when we talk about a poet from the Fatimid state, we find that nature - especially spring and its flowers - in that period took its take from literature and represented a phenomenon for many Among the
... Show MoreObjectives: The study aims to assess the QOL for parents of a child with autism Methodology: A descriptive study was conducted on parents of autistic child in Baghdad city. A purposive (non-probability) sample of (156) parents, (78) mothers and (78) fathers of (78) autistic children who are clients and receive care in the private specialization centers for autism were selected to participated in the current study. The study used a self- administrative questionnaire for data collection. Results: The findings indicated that both parents (mothers and fathers) were participated in this study, and they comprised
This study research to Showing The impact of the integration process on the quality of Insurance service and analyze the impact financially to determine whether there is any impact on the quality of the insurance service, in addition to identifying the obstacles that impede the merger between the insurance companies, insurance and the appropriate proposals for its' application and benefit from the benefits achieved.
The importance of The study lies in the fact that it is an important and vital spotlight that is becoming increasingly important in the world to confront the various difficulties and crises that have occurred recently in light of the liberalization of international trade, globalization a
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