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.
يهدف البحث الحالي الى استكشاف علاقات التفاعل والتاثير بين الاحتكام للمكانة والتوجه للفردية– الجماعية والدمج التنظيمي مستنداً على مزج اختلاف القيم الشخصية مع افكار نظرية الهوية الاجتماعية لبلورة نموذج البحث. وفي ضوء هذا تم صياغة عدد من الفرضيات التي توضح علاقات التفاعل ما بين ابعاد الاحتكام للمكانة والتوجه للفردية– الجماعية للتنبؤ بوجود الدمج التنظيمي. جمعت البيانات باستخدام استمارة الاستبيان ووزع
... Show MoreThis book includes three main chapters: 1. Functions & Their Derivatives. 2. Minimum, Maximum and Inflection points. 3. Partial Derivative. In addition to many examples and exercises for the purpose of acquiring the student's ability to think correctly in solving mathematical questions.
Compounds were prepared from In2O3 doped SnO2 with different doping ratio by mixing and sintering at 1000oC. Pulsed Laser Deposition PLD was used to deposit thin films of different doping ratio In2O3: SnO2 (0, 1, 3, 5, 7 and 9 % wt.) on glass and p-type wafer Si(111) substrates at ambient temperature under vacuum of 10-3 bar thickness of ~100nm. X-ray diffraction and atomic force microscopy were used to examine the structural type, grain size and morphology of the prepared thin films. The results show the structures of thin films was also polycrystalline, and the predominate peaks are identical with standard cards ITO. On the other side the prepared thin films declared a reduction of degree of crystallinity with the increase of doping ra
... Show More Thsst researcher problem of delays faced by researchers are all waiting to evaluate their standards by the experts who must take their views to extract the truth Virtual important step first step in building standards whatsoever, then the difference of opinion among experts about the paragraphs Whatever the scope of their functions, leading to confusion in maintaining these paragraphs or delete? Or ignore the views and opinion of the researcher to maintain the same? Or as agreed upon with the supervisor if he was a student? Especially if the concepts of a modern new building.
Therefore, the researcher sought to try to find a solution to her problem to conduct an experiment to test building steps
Heritage reflects peoples' memory and essence of nations. Thus, this divan was really the material and tool for writers in general and poets in specific both in their artificial innovations . Accordingly, modern writers have endeavored to bring heritage back in all its details and occurrences. Abdullwahab Al-Bayati's experience had reflected his innovative and strong link with the humanitarian heritage, in that heritage in view of Al-Bayati means both the humanitarian expertise and gains that are able to extend from past to future passing through the present.From this, the poet had not disconnected his strong link with the Arab poetic heritage .Thus, the poet had utilized the Arab poetic heritage in expressing on the Arab contrary realit
... Show MoreThis study discussed the effects of doping with silver (Ag) on the optical and structural properties of
CdO nanoparticles at different concentrations 0, 1, 2, 3, 4, 5 wt% prepared by the precipitation method. The
materials were annealed at 550˚C for 1 h. The structural, topographical, and optical properties were
diagnosed by X-ray diffraction analysis, atomic force instrument, and visible and ultraviolet spectrometers.
The results show that the average diameter of the grains depends on the percentage of added silver to the
material, as the diameter decreased from 88.8 to 59.7 nm, and it was found that the roughness increased from
5.56 to 26.5. When studying the optical properties, it was noted that th
Abstract: Background: Drug toxicity and chemotherapeutic side effects negatively impact the quality of life of breast cancer patients. Objectives: to evaluate the efficacy of pharmaceutical Interventions (PI) on quality of life (QOL)Among chemotherapy intake breast cancer women. Method: A pre-post interventional study was carried out at the chemotherapy ward of Alhabobi Hospital in Alnasiriyah City. Eligible patients received comprehensive pharmaceutical care and a self-compiled Breast Cancer Patients Medication Knowledge Guide pamphlet. Each patient received two sessions, the first at baseline and the second after 7, 14, or 21 days depending on the next taking dose of chemotherapy. Each session lasted for approximately 15-30 minutes. Par
... Show MoreThe human kidney is one of the most important organs in the human body; it performs many functions
and has a great impact on the work of the rest of the organs. Among the most important possible treatments is
dialysis, which works as an external artificial kidney, and several studies have worked to enhance the
mechanism of dialysate flow and improve the permeability of its membrane. This study introduces a new
numerical model based on previous research discussing the variations in the concentrations of sodium,
potassium, and urea in the extracellular area in the blood during hemodialysis. We simulated the differential
equations related to mass transfer diffusion and we developed the model in MATLAB Simu
In recent years, the positioning applications of Internet-of-Things (IoT) based systems have grown increasingly popular, and are found to be useful in tracking the daily activities of children, the elderly and vehicle tracking. It can be argued that the data obtained from GPS based systems may contain error, hence taking these factors into account, the proposed method for this study is based on the application of IoT-based positioning and the replacement of using IoT instead of GPS. This cannot, however, be a reason for not using the GPS, and in order to enhance the reliability, a parallel combination of the modern system and traditional methods simultaneously can be applied. Although GPS signals can only be accessed in open spaces, GP
... Show MoreThe time spent in drilling ahead is usually a significant portion of total well cost. Drilling is an expensive operation including the cost of equipment and material used during the penetration of rock plus crew efforts in order to finish the well without serious problems. Knowing the rate of penetration should help in speculation of the cost and lead to optimize drilling outgoings. Ten wells in the Nasiriya oil field have been selected based on the availability of the data. Dynamic elastic properties of Mishrif formation in the selected wells were determined by using Interactive Petrophysics (IP V3.5) software based on the las files and log record provided. The average rate of penetration and average dynamic elastic propert
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