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.
This research aims to present a proposed model for disclosure and documentation when performing the audit according to the joint audit method by using the questions and principles of the collective intelligence system, which leads to improving and enhancing the efficiency of the joint audit, and thus enhancing the confidence of the parties concerned in the outputs of the audit process. As the research problem can be formulated through the following question: “Does the proposed model for disclosure of the role of the collective intelligence system contribute to improving joint auditing?”
The proposed model is designed for the disclosure of joint auditing and the role
... Show MoreMedia studies have focused mostly on the issue of the mental image because the image that is formed in the mind has become not only a photo of a human being and having kept for himself. This image has an outside influence which may sometimes up to the formation of the fate of others and it sometimes includes individuals and groups together.
This study comes in the context of identifying the image of Iraqi political parties among Iraqi university students and the nature of the view that students have in their minds about these parties.
Chapter one includes the problem of the research, the importance of the study, the goals and method used. Chapter two is divided into two sections: section one deals with the concept of the mental i
This research aimed to diagnose the perception based on Telecommunications of Iraq to the importance of activating knowledge management marketing in possession, as well as Indication of impediments to activate the management of marketing knowledge in the researched companies, also aimed to show the extent of the existence of significant differences in perception based on Telecommunications Iraqi importance of activating the management marketing knowledge in possession. To achieve the objectives of this research, the questionnaire was developed and distributed to a sample of telecommunications companies in the city of Sulaimaniya, was selected on the criterion according to the company's life in terms of seniority in the telecommunication
... Show MoreThis article studies a comprehensive methods of edge detection and algorithms in digital images which is reflected a basic process in the field of image processing and analysis. The purpose of edge detection technique is discovering the borders that distinct diverse areas of an image, which donates to refining the understanding of the image contents and extracting structural information. The article starts by clarifying the idea of an edge and its importance in image analysis and studying the most noticeable edge detection methods utilized in this field, (e.g. Sobel, Prewitt, and Canny filters), besides other schemes based on distinguishing unexpected modifications in light intensity and color gradation. The research as well discuss
... Show MoreOptimization of gas lift plays a substantial role in production and maximizing the net present value of the investment of oil field projects. However, the application of the optimization techniques in gas lift project is so complex because many decision variables, objective functions and constraints are involved in the gas lift optimization problem. In addition, many computational ways; traditional and modern, have been employed to optimize gas lift processes. This research aims to present the developing of the optimization techniques applied in the gas lift. Accordingly, the research classifies the applied optimization techniques, and it presents the limitations and the range of applications of each one to get an acceptable level of accura
... Show MoreThis study aims at investigating the partial Islamic rules of preparing and distributing cartoons in order to issue an overall Islamic rul. To reach an end, descriptive and analytical approaches are adopted to clarify the nature of cartoons and other related concepts. The researcher, as well, with reference to verses of the Holy Quran, tradition (Hadith) and Islamic jurists, adopts a deductive approach to issue Islamic rules related to the industry of cartoons and it's distribution
The study consists of three sections. The first Section addresses the following issues: Definition animation; and related wordy. The second Section: Origin of Cartoon's history and it's negative and positive effects. The third Section: Islamic rules related
Onchocerciasis is an infection with cutaneous, ocular and systemic manifestations caused by the filarial nematode Onchocerca volvulus, which is transmitted by the bite of various species of the anthropophilic blood-sucking Simulium vectors (black flies). Onchocerciasis is endemic to the savannahs and rainforests of subequatorial Africa and in some countries of the Arabian Peninsula, notably Yemen and Oman, and in Central America, and the Amazon basin of South America. Onchocercomas, which can be defined as subcutaneous fibrous nodules containing adult worms, are among the variable clinical manifestations of this infestation; they are either superficial or deep and usually located over bony prominences. In this paper we report a case of an o
... Show MoreEmotion could be expressed through unimodal social behaviour’s or bimodal or it could be expressed through multimodal. This survey describes the background of facial emotion recognition and surveys the emotion recognition using visual modality. Some publicly available datasets are covered for performance evaluation. A summary of some of the research efforts to classify emotion using visual modality for the last five years from 2013 to 2018 is given in a tabular form.