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 current research aims to investigate the skills of the intended meaning beyond the context when reading poetry among fifth literary students. To achieve the aim of the research, the researcher has followed the descriptive approach and used two tools: an open questionnaire that includes an inquiry about the skills of the intended meaning beyond the poetic context, and a closed questionnaire that were examined by the juries, and modified accordingly. Besides, its validity and stability were examined by applying the study on an exploratory sample of (15) teachers to reach its final version and determine the time required to answer it. Then, the researcher applied it on the research sample of (9
... Show MoreSilver sulfide and the thin films Ag2Se0.8Te0.2 and Ag2Se0.8S0.2 created by the thermal evaporation process on glass with a thickness of 350 nm were examined for their structural and optical properties. These films were made at a temperature of 300 K. According to the X-ray diffraction investigation, the films are polycrystalline and have an initial orthorhombic phase. Using X-ray diffraction research, the crystallization orientations of Ag2Se and Ag2Se0.8Te0.2 & Ag2Se0.8S0.2 (23.304, 49.91) were discovered (XRD). As (Ag2Se and Ag2Se0.8Te0.2 & Ag2Se0.8S0.2) absorption coefficient fell from (470-774) nm, the optical band gap increased (2.15 & 2 & 2.25eV). For instance, the characteristics of thin films made of Ag2Se0.8Te0.2 and Ag2Se0.8S0.2
... Show MoreABSTRACT
This study aimed to choose top stocks through technical analysis tools specially the indicator called (ratio of William index), and test the ability of technical analysis tools in building a portfolio of shares efficient in comparison with the market portfolio. These one technical tools were used for building one portfolios in 21 companies on specific preview conditions and choose 10 companies for the period from (March 2015) to (June 2017). Applied results of the research showed that Portfolio yield for companies selected according to the ratio of William index indicator (0.0406) that
... Show MoreThe present work concerns with simulating unsteady state equilibrium model for production of methyl oleate (biodiesel) from reaction of oleic acid with methanol using sulfuric acid as a catalyst in batch reactive distillation. MESHR equations of equilibrium model were solved using MATLAB (R2010a). The validity of simulation model was tested by comparing the simulation results with a data available in literature. UNIQUAC liquid phase activity coefficient model is the most appropriate model to describe the non-ideality of OLAC-MEOH-MEOL-H2O system. The chemical reactions rates results from EQ model indicating the rates are controlled by chemical kinetics. Several variables was studied such as molar ratio of methanol to oleic acid 4:1, 6:1
... Show MoreAppending is a morphological term which means the addition of one or two letters to a structure to be similar to other structures of well-known abstractor additional nouns and verbs constructions. The goal of appending is to organize what have been expanded linguistically and collect similarities to reduce the syntactic rules. This is because the appended word exists for expanding purposes; however, it has no construction of its own. An appending was included with another construction with mentioning the additional letter. This by itself means that appending as a process is a term that helps organize rather than expand language. Scholars further noticed that the appending letter is not semantically significant, and so it differs from the
... Show MoreObjective: To assess the nurses-midwives' knowledge and practices regarding the management of second stage
of labor and to find out the association between their knowledge and practices and socio-demographic
characteristics and working years and experience.
Methodology: A descriptive study was carried out from March 22nd
, 2008 through 30th June, 2008. A purposive
sample of (75) Nurse-Midwives which was selected from (6) hospitals. A questionnaire was comprised of two
parts: (socio-demographic characteristics and the assessment tool for Nurse-Midwives' knowledge and health
practices performed by them). The questionnaire validity was determined by experts and its reliability was
determined through a pilot study. Th
The aim of the current research is to recognizing the impact of mind and informational strategy on the achievement with the second intermediate students in the grammar of arabic language, the researcher used a partial-set experimental design and intentionally selected a sample out of the second intermediate class from (AL- Markazya Intermediate school) in the district of Hilla, affiliated which belongs to General Directorate of Babylon Education in the year (2020-2021) for applying the experiment. The sample was composed of (50) students, (25) ones for each group, the experimental group and normal one. The researcher balanced between the two groups in various changes including: (the chronological age counted by months, the academic achie
... Show MoreIn this paper the use of a circular array antenna with adaptive system in conjunction with modified Linearly Constrained Minimum Variance Beam forming (LCMVB) algorithm is proposed to meet the requirement of Angle of Arrival (AOA) estimation in 2-D as well as the Signal to Noise Ratio (SNR) of estimated sources (Three Dimensional 3-D estimation), rather than interference cancelation as it is used for. The proposed system was simulated, tested and compared with the modified Multiple Signal Classification (MUSIC) technique for 2-D estimation. The results show the system has exhibited astonishing results for simultaneously estimating 3-D parameters with accuracy approximately equivalent to the MUSIC technique (for estimating elevation and a
... Show MoreAbstract
In this study, the effect of carboxylic methyl cellulose (CMC), and sodium dodcyl benzene sulfonate (SDBS) as an aqueous solution on the drag reduction was investigated. Different concentrations of (CMC) and (SDBS) such as (50, 100, 150, 200, 250, 300, 350, 400, 450, and 500 ppm) were used to analyze the aqueous solution properties, including surface tension, conductivity, and shear viscosity. The optimum four concentrations (i.e., 50, 100, 200, and 300 ppm) of fluid properties were utilized to find their effect on the drag reduction. Two different PVC pipe diameters (i.e., 1" and 3/4") were used in this work. The results showed that blending CMC with SDBS gives
... Show More