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.
It is necessary to use the means of recovery and other means that help to get rid of the effects of fatigue, as the game of badminton and the effectiveness of running 800 meters fall within the mixed system with the superiority of the anaerobic system by more than the air system, so requires the development of energy systems In proportion to the time of the match for badminton players and their travels and high performance and ability to tolerate the high level of lactic acid in the muscles and blood and increase the pain associated with the fatigue that occurs during the performance. In light of the physical and physiological processes of these actions N it should seek through training programs to develop your endurance and wind energy sys
... Show MoreObjective(s): This research aims at evaluating the quality of pulmonary tuberculosis patients life before and after applying the suggested instructional program, and to find out relationships among distribution of an overall assessment quality of life improvement and socio-demographic characteristics variables. Methodology: Self controlled design studying effectiveness of applying instructional program on quality of life for pulmonary tuberculosis patients among sample size (65) patients from primary health care centers/AL-Sadur City sector-the consultation clinic of chest and respiratory diseases at AL
In this work, the modified Lyapunov-Schmidt reduction is used to find a nonlinear Ritz approximation of Fredholm functional defined by the nonhomogeneous Camassa-Holm equation and Benjamin-Bona-Mahony. We introduced the modified Lyapunov-Schmidt reduction for nonhomogeneous problems when the dimension of the null space is equal to two. The nonlinear Ritz approximation for the nonhomogeneous Camassa-Holm equation has been found as a function of codimension twenty-four.
One of the important differences between multiwavelets and scalar wavelets is that each channel in the filter bank has a vector-valued input and a vector-valued output. A scalar-valued input signal must somehow be converted into a suitable vector-valued signal. This conversion is called preprocessing. Preprocessing is a mapping process which is done by a prefilter. A postfilter just does the opposite.
The most obvious way to get two input rows from a given signal is to repeat the signal. Two rows go into the multifilter bank. This procedure is called “Repeated Row” which introduces oversampling of the data by a factor of 2.
For data compression, where one is trying to find compact transform representations for a
... Show MoreThe downhole flow profiles of the wells with single production tubes and mixed flow from more than one layer can be complicated, making it challenging to obtain the average pressure of each layer independently. Production log data can be used to monitor the impacts of pressure depletion over time and to determine average pressure with the use of Selective Inflow Performance (SIP). The SIP technique provides a method of determining the steady state of inflow relationship for each individual layer. The well flows at different stabilized surface rates, and for each rate, a production log is run throughout the producing interval to record both downhole flow rates and flowing pressure. PVT data can be used to convert measured in-situ rates
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A genetic algorithm model coupled with artificial neural network model was developed to find the optimal values of upstream, downstream cutoff lengths, length of floor and length of downstream protection required for a hydraulic structure. These were obtained for a given maximum difference head, depth of impervious layer and degree of anisotropy. The objective function to be minimized was the cost function with relative cost coefficients for the different dimensions obtained. Constraints used were those that satisfy a factor of safety of 2 against uplift pressure failure and 3 against piping failure.
Different cases reaching 1200 were modeled and analyzed using geo-studio modeling, with different values of input variables. The soil wa
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Granulation Technique for Gamma Alumina Catalyst Support was employed in inclined disk granulator (IDG), rotary drum granulator (RD) and extrusion – spheronization equipments .Product with wide size range can be produced with only few parameters like rpm of equipment, ratio of binder and angle of inclination. The investigation was conducted for determination the optimum operating conditions in the three above different granulation equipments.
Results reveal that the optimum operating conditions to get maximum granulation occurred at ( speed: 31rpm , Inclination:420 , binder ratio:225,300% ) for the IDG,( speed: 68rpm , Inclination: 12.50 , binder ratio: 300% ) for the RD and ( speed:1200rpm , time of rotation: 1-2min )for the Caleva
This study aimed to reveal the extent to which the values of social peace are included in the content of social and national studies textbooks of the middle stage in kingdom of Saudi Arabia. To achieve this goal, the researcher used the descriptive analytical approach. The study sample consisted of all developed social and national studies textbooks of the middle stage in kingdom of Saudi Arabia in first and second semester of student books in edition of 1439-1440. The study tool was the analysis card. The study reached the following results: 1-The content of social and national studies textbooks of the middle stage in kingdom of Saudi Arabia as a whole included (38) social peace values of total (40) values, corresponding to the inclusio
... Show MoreThis research presents a new algorithm for classification the
shadow and water bodies for high-resolution satellite images (4-
meter) of Baghdad city, have been modulated the equations of the
color space components C1-C2-C3. Have been using the color space
component C3 (blue) for discriminating the shadow, and has been
used C1 (red) to detect the water bodies (river). The new technique
was successfully tested on many images of the Google earth and
Ikonos. Experimental results show that this algorithm effective to
detect all the types of the shadows with color, and also detects the
water bodies in another color. The benefit of this new technique to
discriminate between the shadows and water in fast Matlab pro
The study presents the test results of Completely Decomposed Granite (CDG) soil tested under drained triaxial compression, direct shear and simple shear tests. Special attention was focused on the modification of the upper halve of conventional Direct Shear Test (DST) to behave as free
head in movement along with vertical strain control during shear stage by using Geotechnical Digital System (GDS). The results show that Free Direct Shear Test (FDST) has clear effect on the measured shear stress and vertical strain during the test. It has been found that shear strength
parameters measured from FDST were closer to those measured from simple shear and drained triaxial compression test. This study also provides an independent check on