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 article examines metaphors as one of the fundamental means used by D. Rubina when writing the novel “Parsley Syndrome” to form images of dolls as equal heroes of the work. The author of the article continues research related to the work of Dina Ilinichna Rubina, a representative of modern Russian prose.
In this paper the method of singular value decomposition is used to estimate the ridge parameter of ridge regression estimator which is an alternative to ordinary least squares estimator when the general linear regression model suffer from near multicollinearity.
An investigation was conducted effect of addition co- solvent on solvent extraction process for two types of a lubricating oil fraction (spindle) and (SAE-30) obtained from vacuum distillation unit of lube oil plant of Daura Refinery. In this study two types of co-solvents ( formamide and N-methyl, 2, pyrrolidone) were blended with furfural to extract aromatic hydrocarbons which are the undesirable materials in raw lubricating oil, in order to improve the viscosity index, viscosity and yield of produced lubricating oil. The studied operating condition are extraction temperature range from 70 to 110 °C for formamide and 80 to 120 °C for N-methyl, 2, pyrrolidone, solvent to oil ratio range from 1:1 to 2:1 (wt./wt.) for furfural with form
... Show MoreSome structures such as tall buildings, offshore platforms, and bridge bents are subjected to lateral loads of considerable magnitude due to wind and wave actions, ship impacts, or high-speed vehicles. Significant torsional forces can be transferred to the foundation piles by virtue of eccentric lateral loading. The testing program of this study includes one group consists of 3 piles, four percentages of allowable vertical load were used (0%, 25%, 50%, and 100%) with two L/D ratios 20 and 30, vertical allowable load 110 N for L/D = 20 and 156 N for L/D = 30. The results obtained indicate that the torsional capacity for pile group increases with increasing the percentage of allowable vertical load, when the percentage of allowable vertica
... Show MoreIncreased interest in the subject of the image because of its great and growing link to the life of the individual and society and its impact on the overall political, economic and cultural conditions. This interest is no longer confined to the images of people or institutions, but has become beyond that to the images of countries and peoples and the impact on bilateral relations between them,
However, we find that the image of the Iraqi abroad remained vague and has not been scientifically recognized and the most that we can generalize are the features of the image of Arabs and Muslims abroad; and assume that the image of the Iraqi applies to them as the Iraqi is in the end an Arab or Muslim.
Based on this, the research
... Show MoreThe marshes are one of the important environmental features affecting human and animal systems, so the studying of changes they undergo is one of the important topics. This study is concerned with the changes occurring in the Al Saadya marsh for the period from 1987 to 2017 exclusively in the winter season (the marshes’ revival season in Iraq revive). In order to inspect the changes in this marsh, we choose 7 years to cover the study period as a criterion years, namely 1987, 1990, 1995, 2000, 2007, 2014 and 2017. The “Maximum Likelihood” classifier was used to separate the stacked land cover features, where the minimum overall accuracy ratio that recorded for all years of study was 96%. The results revealed that Al-Saadya marsh went t
... Show Morethe contemporary Arab scholars deal with semiotics as an approach that helps them understand the texts, its meaning, and its structural functionalism . that’s why every now and then we find some
studies and researches using semiotics as an approach in study and comparatives, some of them even used the semiotic approach in analyzing old and new texts, while others think that semiotic holds and important place in critical approaches .
even though some of them considers semiotic just a trend of fashion this really didn’t lessen the value of semiotic as a scientific and procedural approach in literary and media studies as well as in analyzing literary and journalistic texts. for this reason it is considered as an important approa
Malaysia has been supported by one of the high-speed fiber internet connections called TM UniFi. TM UniFi is very familiar to be used as a medium to apply Small Office Home Office (SOHO) concept due to the COVID-19 pandemic. Most of the communication vendors offer varieties of network services to fulfill customers' needs and satisfaction during the pandemic. Quality of Services is queried by most users by the fact of increased on users from time to time. Therefore, it is crucial to know the network performance contrary to the number of devices connected to the TM UniFi network. The main objective of this research is to analyze TM UniFi performance with the impact of multiple device connections or users' services. The study was conducted
... Show MoreBackground: Job satisfaction remains as an important concern for both employer and employee. A high-quality teaching staff is the cornerstone of a successful educational system. One step in developing a high quality faculty understands the factors associated with teaching quality and retention. One of these factors is job satisfaction, which has been studied widely by organizational researchers.Objectives: To evaluate the extent of job satisfaction of teaching staff working at AL-Kindy College of medicine and to identify some work-related factors associated with job satisfaction.Methods: A cross- sectional study was carried out. A convenient sample of 50 teaching staff, who had a teaching job at different scientific departments at AL-Kin
... Show More