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 aim of this research is to apply the concept of total value management to improve the process design of producing the toothpaste in Al Mammon factory one of the in the general company of food industry. The concept of total value management is concerning with achieve more than one values which are important for the customers as these values are related to the customers satisfaction. The research problem is that the factory did not measure the effectiveness of process design as this company has weakness in analyzing this effectiveness in synchronies with total value management. On the other side, the company did not give more attention to the cost of products and selling prices within the value cost/ profit which is one of the
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Our research was launched in the study of the sustainable conflict of globalization and the rebalancing of the great powers that have made life on the earth unstable and insecure over the past and present eras, the purpose of which is to pay attention to the waste and instability that human societies are exposed to in different proportions between abstract right and continuous deviation.
The purpose of the study is to show the loss, waste and backwardness in managing and governing societies towards private interests, away from the standards of good institutional governance.
The study’s design was based on two demands, the first on the nature and eternity of
... Show MoreThe research in Islamic history is considered a title for the glory of the nation and a mirror for the intellectual and mental maturity of the men of the Islamic state who played an important role in saving humanity from darkness to light and from ignorance to knowledge and to show their position in building the Islamic state, and to highlight the importance of their conquests of neighboring cities and the expansion of Islam, and for this reason they appear The importance of writing on the topic (The Battle of Dumat al-Jandal and its impact on the era of the Prophethood and the Rightly Guided Caliphate). The reason for choosing this topic was to show the status of Dumat al-Jandal and its importance in the Islamic state and its great role
... Show MoreThe study aims to reveal the degree of application of the alternative evaluation strategy in social studies in public education in the Kingdom of Saudi Arabia. It also aims to identify the opinions of experts on how to implement this. The study adopted the mixed methodology, which represented in the descriptive-analytical method, and qualitative methods through the grounded theory. The study used two tools namely: a questionnaire for assessments of social studies teachers and semi-structured interview questions. The results of the study showed a medium degree of appreciation for the application of alternative evaluation strategies by social studies teachers in general education with an average of (2.28). The results also showed that ther
... Show MoreHumanoids or bipedal robots are other kinds of robots that have legs. The balance of humanoids is the general problem in these types when the other in the support phase and the leg in the swing phase. In this work, the walking pattern generation is studied by MATLAB for two types of degrees of freedom, 10 and 17 degrees of freedom. Besides, the KHR-2HV simulation model is used to simulate the experimental results by Webots. Similarly, Arduino and LOBOT LSC microcontrollers are used to program the bipedal robot. After the several methods for programming the bipedal robot by Arduino microcontroller, LOBOT LSC-32 driver model is the better than PCA 96685 Driver-16 channel servo driver for programming the bipedal walking rob
... Show Moreان وضع معايير دولية محاسبية على شكل نماذج وارشادات عامة تؤدي باصحاب القرارات الاقتصادية استخدام معايير المحاسبة الدولية عند اعداد وتجهيز القوائم والبيانات المالية اصبح مطلب اساسي وضرورة ملحة لمختلف الاطراف في المجتمع الحالي فهذه المعايير قد اثمرت في معالجة الامور المحاسبية على الصعيد المحلي والاقليمي والدولي. وان عدد كبير من الدول اعتمدت هذه المعايير فقد تجاوزت 150 بلدا. مما نتج عنه ازالة الفوارق الكث
... Show MoreTime is an essential element of contracts، as there is an independent in many parts of each contract، but the time dimension has a significant impact on the provisions of all contracts and is not limited to a particular range of contracts، and French and Arab jurists alike have called for this dimension to be given special attention، and as a result the French legislator has introduced the term duration of the contract، to try to limit the temporal elements، to clarify their provisions and to distinguish between them in decree131/2 016، but for our Arab country it did not receive the appropriate answer. The problem of duration in contracts relates to the lack of clarity of the idea، and then to confuse the various time terms in the
... Show MoreA group of acceptance sampling to testing the products was designed when the life time of an item follows a log-logistics distribution. The minimum number of groups (k) required for a given group size and acceptance number is determined when various values of Consumer’s Risk and test termination time are specified. All the results about these sampling plan and probability of acceptance were explained with tables.
Heat treatment by solid solution method in the ?+? phase region was used at 970°C for Ti-5Al-2.5Fe alloy. The specimens cooled under different cooling media [water quenched (WQ), air cooled (AC) and furnace cooled (FC)], and subsequently aged at 550°C for 4 hours. Five specimens from each treatment were immersed in simulated body fluid SBF for a period of time (3 months). The dependence of corrosion rate on compositional variation in the phases resulted from various type of cooling rates are discussed based on immersion tests. The EDXA results show the precipitation of phosphate and calcium compounds on the alloy after 3 months of immersion in blood plasma solution forming a bone-like apatite, which enhanced the alloy biocompatibility ma
... Show MoreBaghdad and the other Iraqis provinces have witnessed many of celebrations which have the significant effect on the souls of Arabic and Islamic people in general , and Iraqi people, especially the birthday and death of two al-kadhimen Imams(peace upon them) and others .From here the researcher begin to study the visiting of imam kadhimen (peace upon him) on 25 Rajab the commemoration of his sacrifice, simply because have implications of religious, ideological and cultural sectors which represents in finding the greatest flow of visitors .the problem of research appeared due to the clear difference in number of visitors during one day, beside the significant increase in number of visitors throu
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