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.
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
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In 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 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
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Bac 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
Silver 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 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
Objective(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
In this study, nano TiO2 was prepared with titanium isopropoxide (TTIP) as a resource to titanium oxide. The catalyst was synthesized using phosphotungstic acid (PTA) and, stearyl trimethyl ammonium bromide (STAB) was used as the structure-directing material. Characterization of the product was done by the X-ray diffraction (XRD), X-ray fluorescent spectroscopy (XRF), nitrogen adsorption/desorption measurements, Atomic Force Microscope (AFM) and Fourier transform infrared (FTIR) spectra, were used to characterize the calcined TiO2 nanoparticles by STAB and PWA. The TiO2 nanomaterials were prepared in three crystalline forms (amorphous, anatase, anatase-rutile). The results showed that the
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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?
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