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 present article concerns one of the objects of media sociology under construction. The transformation of the rites in the use of the television contents in the era of digital technologies and media convergence. By an analytic contextual approach, based on the study of the uses, we formulate the following hypothesis: so many changes in the rites of uses are real, in particular at the young people, so, many pieces integer of the everyday life remain impervious to these changes, and it is true under the influence of a slowness of the social and cultural orders, rooted for a long time in the traditional social fabric. We shall then try to bring a sociological look to this societal, cultural, and communicational object that is the pas
Objective: 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
Abstract
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 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 MoreThe current study is concerned with presenting a descriptive study of the history of the city of Astrabath in the sixth century AH. The problem that the research tried to answer is represented in the investigation of historical news, and the study of the most prominent cultural aspects which characterizing that city. The research also aims to reach the geographical location of that city, its name and its suburbs. The importance of the research lies in the knowledge of everything related to the role of the civilization of Astrabath, as well as tracing the entry of the Arabs to it, so that it became a cultural, economic and scientific center and its historical role in the sixth century AH. The research reminde us with the scientific role o
... Show MoreThe objective of the research is to shed light on the nature of the impact of the activities of the national strategy for poverty alleviation in achieving the goals of sustainable development, and the research problem was represented by Is there an effect of the activities of the national strategy for poverty reduction in achieving the goals of sustainable development? and represents the field of research in the Ministry of Labor and Social Affairs For the years (2012-2016) and the results of the sustainable development goals indicators for the years (2012-2016), the ready-made statistical program (SPSS ver.10) was used to calculate the percentages, multiple linear regression equation, the F test and the R2 coefficient, and the research
... Show MoreThe auditor has a role in allocating joint costs in the gas industry, and the auditor's procedures are considered as systematic critical examination, analysis and evaluation of everything related to costs in general and joint costs in the gas industry in particular, with the aim of controlling the joint costs of gas industry products, and knowing the share of the cost of each product from the total industry costs Gas products reflect the reality of the company's performance by discovering weaknesses, defects and any errors, to ensure increased effectiveness and efficiency of the parties concerned with auditing them and imposing control and control over the company's resources, as well as
... Show MoreBac kground:
Failure is the state or condition of not meeting a desirable or intended objective, and may be viewed as the opposite of success; students always have a question "Why did I get this grade. On the contrary success leads towards new sources of earning, in fact there are a lot of interacting factors play such extrinsic and extrinsic to reach success.
Objec t i ves :
To explore internal and external factors causing students failure in medical college and to reconnoiter factors improve academic performance.
Methods: A cross-sectional study, conducted in Al Kindy College of Medicine, for the period from November 8th 2012 to May 1st 2013. Formal ethical considerations were obtained about participation and methodology. A
The aim of this paper is to present the numerical method for solving linear system of Fredholm integral equations, based on the Haar wavelet approach. Many test problems, for which the exact solution is known, are considered. Compare the results of suggested method with the results of another method (Trapezoidal method). Algorithm and program is written by Matlab vergion 7.
Nitrogen (N) is a key growth and yield-limiting factor in cultivated rice areas. This study has been conducted to evaluate the effects of different conditions of N application on rice yield and yield components (Shiroudi cultivar) in Babol (Mazandaran, Iran) during the 2015- 2016 season. A factorial experiment executed of a Randomized Complete Block Design (RCBD) used in three iterations. In the first factor, treatments were four N amounts (including 50, 90, 130, and 170 kg N ha-1), while in the second factor, the treatments consisted of four different fertilizer splitting methods, including T1:70 % at the basal stage + 30 % at the maximum tillering stage, T2:1/3 at the basal stage + 1/3 at the maximum ti
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