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.
Investigation of the adsorption of Chromium (VI) on Fe3O4 is carried out using batch scale experiments according to statistical design using a software program minitab17 (Box-Behnken design). Experiments were carried out as per Box-Behnken design with four input parameters such as pH (2-8), initial concentration (50–150mg/L), adsorbent dosage (0.05–0.3 g) and time of adsorption (10–60min). The better conditions were showed at pH: 2; contact time: 60 min; chromium concentration: 50 mg/L and magnetite dosage: 0.3 g for maximum Chromium (VI) removal of (98.95%) with an error of 1.08%. The three models (Freundlich, Langmuir, and Temkin) were fitted to experimental data, Langmuir isotherm has bette
... Show MoreInvestment in high education is considered to be most important factors of production which the return an individual and social than economic returns found by searching the growing problem of unemployment, especially among youth graduates, where the unemployment rate in 2010 (50%) of these high rates have led to increased migration of scientific minds graduate recently, "to search for job opportunities outside Iraq for not hiring functions and this is in vain" clear "in the human and financial resources lead to structural imbalances in the Iraqi economy. When calculating the correlation coefficient between the graduates and the unemployment rate where it reached (0.21) emerged from the results of
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Background: The prevalence of both obesity & diabetes are increasing all over the world & more in women. They have a negative impact not only on morbidity & mortality but also on quality of life.
Objectives: To assess the HRQoL with a specific comparison between obese & normal weight among wo
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The objective of drilling parameters optimization in Majnoon oilfield is to arrive for a methodology that considers the past drilling data for five directional wells at 35 degree of inclination as a baseline for new wells to be drilled. Also, to predicts drilling performance by selecting the applied drilling parameters generated the highest rate of penetration (ROP) at each section. The focal point of the optimization process is to reduce drilling time and associated cost per each well. The results of this study show that the maximum ROP could not be achieved without sufficient flow rate to cool and clean the bit in clay intervals (36" and 24") hole sections. Although the influence of combination of Weight on Bit (WOB), Round per minute
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Avery large numbers of articles are made by powder metallurgical methods using electrolytically reduced metal powders. Iron powder is one of these powders which play an important role in this field. Its preparation by electrolytic method is economic in comparison with the traditional methods (Atomization and carbonyl processes).
An electrochemical cell consisting of two electrodes (stainless steel cathode and iron anode, 99.9%) was used to study the electrolytic preparation of iron powder with particle size less than 106µm directly as powde1y form. Ferrous sulphate electrolyte was used containing sodium chloride as a stabilizing agent. The produced powder was thoroughly washed with an acidified distilled water and absolute ethan
... Show MoreThis work describes the effect of temperature on the phase transformation of titanium dioxide (TiO2) prepared using metal organic precursors as starting materials. X-ray diffraction (XRD) was used to investigate the structural properties of TiO2 gels calcined at different temperatures (300, 500, 700) ?C. the results showed that the samples have typical peaks of TiO2 polycrystalline brookite nanopowders after calcined at (300 ?C), which confirmed by (111), (121), (200), (012), (131), (220), (040), (231), (132) and (232) diffraction peaks. Also, XRD diffraction spectra showed the presence of crystallites of anatase with low proportion of rutile phase where calcined at (500 ?C), while rutile phase domains at (700 ?C). The crystallite size of
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In this paper the oscillation criterion was investigated for all solutions of the third-order half linear neutral differential equations. Some necessary and sufficient conditions are established for every solution of (a(t)[(x(t)±p(t)x(?(t) ) )^'' ]^? )^'+q(t) x^? (?(t) )=0, t?t_0, to be oscillatory. Examples are given to illustrate our main results.
Abstract\
Dealing economic units at the present time with an industrial environment characterized by competitiveness and the pace of change and its strength as a result of this changing environment shall be on those who made it to adopt strategies that allow them to confront these variables and work in order to meet the market requirements of quality and price appropriate products to suit and the demand for those products and conditions to maintain
its competitive position and its development.
As a result, it became the subject of competitiveness in recent years and enjoys widespread attention at the global level. And in order to keep up
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This research aims to apply the Performance Focused Activity Based Costing System in the offices of scientific and advisory services at the University of Technology for the purpose of measuring the cost of services provided by these offices in order to reduce costs. To test the hypothesis of the research, the research was applied in the consulting offices of the University of Technology through the financial statements for the year ending 12/31/2017 of the Scientific and Consulting Services Office of the University of Technology, because the data of these years were issued and audited by the Federal Office of Financial Supervision.
A number of
... Show MoreBackground: Postpartum hemorrhage is an important cause of maternal morbidity and mortality. Considerable difference of opinion exist regarding the optimal approach to the management of the 3rd stage of labour, practice varies between countries &between units.Objectives: To evaluate the effectiveness of intra umbilical vein injection of oxytocin and umbilical cord driange in shortening the duration of third stage of labour.Patient and Methods: In this randomized controlled study, 100 women were enrolled in this study they divided into three groups. (Group 1 ,N =30 )received 20 units of oxytocin diluted in 20 ml 0.9% saline solution injected in the umbilical vein after clamping.(Group 2, N = 34) placental cord drainage.(Group 3,
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