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 goal beyond this Research is to review methods that used to estimate Logistic distribution parameters. An exact estimators method which is the Moment method, compared with other approximate estimators obtained essentially from White approach such as: OLS, Ridge, and Adjusted Ridge as a suggested one to be applied with this distribution. The Results of all those methods are based on Simulation experiment, with different models and variety of sample sizes. The comparison had been made with respect to two criteria: Mean Square Error (MSE) and Mean Absolute Percentage Error (MAPE).
Investigation of the adsorption of acid fuchsin dye (AFD) on Zeolite 5A is carried out using batch scale experiments according to statistical design. Adsorption isotherms, kinetics and thermodynamics were demonstrated. Results showed that the maximum removal efficiency was using zeolite at a temperature of 93.68751 mg/g. Experimental data was found to fit the Langmuir isotherm and pseudo second order kinetics with maximum removal of about 95%. Thermodynamic analysis showed an endothermic adsorption. Optimization was made for the most affecting operating variables and a model equation for the predicted efficiency was suggested.
The 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 MoreObjectives: The study aims to identify the effects of an educational program on patients’ knowledge about vascular access care and to find out the relationship between patients knowledge scores and their selected demographic variable. &
... Show MoreQuality function deployment tool is trying to improve health services through this study that will be applied in health sector environment , and be based on applying quality function deployment tool (QFD) TO preferable evaluation of main patients requirements in order to determine the technical requirements that need most attention across improving and developing health services .
Main requirements are determined to patients lying in the hospital (under research) which is (educational Baghdad \ medicine city office) in Baghdad, and other technical requirements through pers
... Show More
Objective: The aim of this study is to identify the impact of training education program applied on
nurse-midwife practice concerning care during third stage of labor in labor room. Examine the
relationship between their knowledge regarding practices and some Demographic information’s.
Methodology: A quasi-experimental design conducted on non-probability (purposive) sample of fifty
two nurse-midwives selected during period from3
th August to 10thNovember 2011. The study is
conducted at the Ministry of Health (Baghdad health directorate in Al-Karhk and Al-Risafa sector) in
four hospitals. The questionnaire form is consisted of three parts which included demographic data,
knowledge concerning practice during third
International news websites, including Russia Today, pay special attention to the media image of Afghan women, especially after the Taliban movement took control of Afghanistan. Therefore, it was necessary to know the image of the Afghan woman, the fate of the rights she acquired in recent years, and the transformations that affected her after the Taliban took control of the government, and studied them on international news sites, specifically Russia Today.
The researcher summarized the problem of this study in the following question: What is the media image of the Afghan woman on the Russia Today news site?
... Show More
(1)
Praise be to God, Lord of the worlds, and peace and blessings be upon our master Muhammad, and upon his whole family and companions, but after: God Almighty has instituted types of acts of worship and classes of obedience that, if performed by the servant, would link him with his Creator and connect with his Lord. And for the sake of these worship, and the greatest of them: the worship of i'tikaaf, for souls need rest and recuperation from the struggle of life and its concerns, concerns and anguish, and people differ in their attitudes and interests in the means of recreation, and many people consider the outing and travel the best way in which they breathe from their toil and toil, and reclaim their strength and the advised adult He fin
... Show MoreCloud computing is the new technological trend for future generations. It represents a new way to use IT resources more efficiently. Cloud computing is one of the most technological models for developing and exploiting infrastructure resources in the world. Under the cloud, the user no longer needs to look for major financing to purchase infrastructure equipment as companies, especially small and medium-sized ones, can get the equipment as a service, rather than buying it as a product. The idea of cloud computing dates back to the sixties of the last century, but this idea did not come into actual application until the beginning of the third millennium, at the hands of technology companies such as Apple, Hp, IBM, which had
... Show MoreObjective(s): The present study aims at identifying the Iraqi Colleges of Nursing Deans' leadership
behaviors effectiveness and faculty members' motivation towards work in these colleges.
Methodology: Descriptive design has been used for the sample survey manner, which is the
appropriate approach to the study of social phenomena in the field where provides data on the reality of
these phenomena and relations between the causes and consequences and an analysis of it and perhaps
the factors affecting it and how it appears. The study relies on a questionnaire to collect data from the
participants which is composed of (86) items distributed on three axes: First, the demographic
characteristics which are composed of (8) i