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.
The selective information broadcasting service is one of the important services in libraries and information centers, as it is the link between the source and the beneficiary and between related sources, as it links similar sources through keywords and then sends them to beneficiaries, which contributes to reducing the time and effort spent by beneficiaries in obtaining sources or information. Therefore, the application of this service is an important matter and gives a positive indicator in the progress of the library towards the integration of its services. From this standpoint, this research came to answer some questions, including: 1. What are the outlets for beneficiaries (the research community) in obtaining information sources? 2. Wh
... Show MoreThe research aimed to identify the effectiveness of instructional design according to whole brain theory of Herman in the achievement of chemistry at the fifth scientific students at a secondary school of the General Directorate for Educational in Diyala / Baladruz in Iraq. The research sample Consisted of (57 student, (29) students as experimental group studied according to instructional design strategies for whole brain theory of Herrmann and (28) a student as a control group studied by the usual way for two semesters, a prepared achievement test as article and objective type of multiple choice, the coefficient stability of alpha-Cronbach equation reached (0.86). The research Results showed the presence of a statistically significant d
... Show MoreIn this study, we review the ARIMA (p, d, q), the EWMA and the DLM (dynamic linear moodelling) procedures in brief in order to accomdate the ac(autocorrelation) structure of data .We consider the recursive estimation and prediction algorithms based on Bayes and KF (Kalman filtering) techniques for correlated observations.We investigate the effect on the MSE of these procedures and compare them using generated data.
With the study of synthesizing new organic compounds and exploring biological potency. Aryldiazenyl derivatives (2-5) were carried out by coupling of diazonium salt of 4-aminoacetophenone (1) and miscellaneous active methylene compounds such as: acetylacetone, ethyl cyanoacetate, dimedone or methyl acetoacetate. Moreover substituted 1,2,3-triazole (7-9) were synthesized by the cyclization of 1-(4-azidophenyl) ethanone (6); (which was obtained by coupling of diazonium salt (1) with sodium azid); with acetylacetone, methyl acetoacetate or methyl cyanoacetate, respectively. The structures of the prepared compounds were promoted by IR, H1NMR and UV/Visible spectra. Further, they were examined in vetro for antibacterial activity against five str
... Show MorePrediction of penetration rate (ROP) is important process in optimization of drilling due to its crucial role in lowering drilling operation costs. This process has complex nature due to too many interrelated factors that affected the rate of penetration, which make difficult predicting process. This paper shows a new technique of rate of penetration prediction by using artificial neural network technique. A three layers model composed of two hidden layers and output layer has built by using drilling parameters data extracted from mud logging and wire line log for Alhalfaya oil field. These drilling parameters includes mechanical (WOB, RPM), hydraulic (HIS), and travel transit time (DT). Five data set represented five formations gathered
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importumt educational institution as (kindergartens) need teachers which qualified ownes modalities in their education for children , as Marzanu method in a way of learning and own methods of crisis management, because the teachers that own those styles of learning ginekindergarten children knowledge and the childrenIeaving based on theMeaing and knowledge and integration of their information, And teachers that earn methods of crisis management provide for the children of the kindergarten security within the educational institution which in turn affect the growth and development of the Child and then abilities, health physical, mental, psychological …etc.., The aims of the current research have identified to recognize: 1- the dimension
... Show MoreThe research dealt with the concepts of the philosophy of values and its epistemological variables according to specific propositions represented in their scientific approaches to value theory in the field of industrial design. As the epistemological propositions of the theory of values were dealt with based on the epistemological fields that dealt with the concept and what values are, starting with the modernist propositions and postmodern, passing through the propositions of sociological and psychological thought, which was a prelude to extracting the concepts of value theory and adopting it in the field of industrial product design. The epistemological approaches to value theory in industrial product design were repr
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The recent study aimed to identify the level of Self- Esteem and its relation to some variables (Gender, Experience years, and Educational stage) among psychologists in schools of the Sultanate of Oman. The study sample consisted of (154) psychologists of both male and female who are working in different stages of study in the schools affiliated to the Ministry of Education in the Sultanate of Oman. The sample of the study consisted of (43) male and (111) female psychologists from (11) governorates of the Sultanate. The descriptive analytical methodology was used. In order to collect data the Self-Esteem questionnaire prepared by the researcher were used. Statistical processing was done using the Statistical Package for Social Sciences (
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The aim of the research is to demonstrate the impact of the salary localization service in enhancing banking competitive advantage. In order to achieve this goal, salary localization was chosen as an independent variable and its impact was studied on the dependent variable, which is the competitive advantage. The research problem lies in the fluctuation of the salary localization service from one bank to another and the impact of this on the competitive advantage. The study sample included five private Iraqi banks, namely (the National Bank of Iraq, the International Development Bank, Assyria International Bank, Al Khaleej Commercial Ban
... Show MoreThe research aims to introduce international valuation standards and to identify the relationship between international valuation standards and international accounting and financial reporting standards in enhancing the quality of financial reporting (appropriate accounting information) through the use of statistical models for the purpose of measuring the property of appropriateness of accounting information through the use of statistical models for the purpose of proving the hypothesis that The research referred to it, and accordingly, the Francis and Kothari models were used to measure the appropriateness of accounting information (the quality of the information). The conclusions reached by the two researchers is that the sett
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