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.
A new series of 5-methoxy-2-mercapto benzimidazole derivatives were synthesized by the reaction of 5-methoxy- 2-mercaptobenzimidazole with chloroacetic acid and affords 2-((5-methoxy-1H-benzo[d]imidazol-2-yl)thio) acetic acid (1),which on cyclization with acetic anhydride and pyridine gives 7- methoxybenzo[4,5]imidazo[2,1-b]thiazol- 3(2H)-one(2), which on condensation with different aryl aldehydes in the presence of anhydrous sodium acetate in glacial acetic acid, furnishes a arylidene thiazolidinone. The purity of the synthesized compounds was confirmed by melting point and TLC.The structures were established by different spectral analysis such as FTIR,1HNMR, and CHN analysis. The newly synthesized compounds (3a-d) were in vivo evaluated f
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This research is drawn from a doctoral dissertation, studying the approach of Sheikh Abd al-Qadir al-Muhajir al-Sanandji al-Kurdi (1303 AH) on the issue of proving the existence of God Almighty.
Sheikh Abd al-Qadir al-Sanandji was one of the scholars well versed in mental sciences. He has many books, all of them in the sciences of speech and wisdom, and among his books is the book (Raising the Eyebrow in Explanation of Ithbat al-Wajib), which is still a manuscript that has not been printed.
Through this book, the researcher studied the evidence of Sheikh Abdul Qadir to prove the existence of God Almighty, and compared it with the evidence of philosophers and theologians.
At the beginning, he presented a study on the import
Objectives: A cross sectional analytic study was carried out to identify the maternal risk factors which
contribute to occurrence of low birth weight, and to determine the statistical significant differences between low
birth weight and maternal risk factors.
Methodology: A purposive sample of (400) woman was selected from AL-Elwyia Maternity Teaching Hospital
and Fatima Al-Zaharia Maternity and Pediatric Teaching Hospital. Data was collected through the interview of
mothers. Questionnaire format was designed and consisted seven parts, demographic variables, and reproductive
variables , Reproductive health variables, complications during the current pregnancy, the mother newborn
variables nutritional status for the m
This paper studied the behaviour of reinforced reactive powder concrete (RPC) two-way slabs under static load. The experimental program included testing three simply supported slabs of 1000 mm length, 1000 mm width, and 70 mm thickness. Tested specimens were of identical properties except their steel fibers volume ratio (0.5 %, 1 %, and 1.5 %). Static test results revealed that, increasing steel fibers volume ratio from 0.5% to 1% and from 1% to 1.5%, led to an increase in: first crack load by (32.2 % and 52.3 %), ultimate load by (36.1 % and 17.0 %), ultimate deflection by (33.6 % and 3.4 %), absorbed energy by (128 % and 20.2 %), and the ultimate strain by (1.1 % and 6.73 %). The stiffness and ductility of the specimens also increased. A
... Show MoreThe research aims to determine the required rate of return according to the Fama and French five-factor model, after strengthening it by adding the indebtedness factor to build the Fama and French six-factor model FF6M-DLE. The effect of the indebtedness factor on the company's profitability and the real value of the ordinary shares calculated according to the (equivalent ascertainment) model and its suitability with the company's situation, and an analysis of the fluctuation between the market value and the real value of the ordinary stocks.
In this research , we study the inverse Gompertz distribution (IG) and estimate the survival function of the distribution , and the survival function was evaluated using three methods (the Maximum likelihood, least squares, and percentiles estimators) and choosing the best method estimation ,as it was found that the best method for estimating the survival function is the squares-least method because it has the lowest IMSE and for all sample sizes
Abstract Infinitives and gerunds are non-finite verb forms which cannot be indicated by tense, number, or person. The construction of non-finite verbs is intricate because of their nature of meanings, forms, and functions. The major problem is that both infinitival and gerundial complements have identical functions and occupy identical positions in the sentences. Thus, there is a confusion in using an infinitival and gerundial forms after aspectual verbs. The selection of either one of these two forms as complements is controlled syntactically or semantically. Moreover, both forms can be used usually with similar predicate but with neat difference in meaning. In addition, there are problems with controlling the use of aspect, since aspectua
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This study aims to identify the reality of using electronic applications in teaching language skills to people with mild intellectual disabilities from the mothers’ perspective. A descriptive approach was used. The electronic questionnaires were administered to the study sample, 122 responses were received from mothers of the students with mild intellectual disability in Hafer Al-Baten schools. The response average rate was 94%. The results showed that there are statistically significant differences that are related to the variant of monthly income as for the barriers to using electronic applications in such schools, whereas there were no differences regarding the variant of monthly income regarding t
... Show MoreIn the era of the digital economy, public organizations need to consolidation the capabilities of entrepreneurial alertness to reduce the risks of sudden transformations and changes, and to find effective mechanisms to discover and invest in environmental opportunities proactively, as this concern has become a knowledge gap in public sector institutions, the current research aims to identify the role of digital competence in influencing on entrepreneurial alertness in the Central Bank of Iraq (CBI), the descriptive analytical approach was used as a research method to describe and analyze the main research variables. digital competence as an explanatory variable includes three dimensions: digital infrastructure, digital integration, and d
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Here, we found an estimation of best approximation of unbounded functions which satisfied weighted Lipschitz condition with respect to convex polynomial by means of weighted Totik-Ditzian modulus of continuity