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.
ABSTRACT This paper has a three-pronged objective: offering a unitary set of semantic distinctive features to the analysis of nominal “hatred synonyms” in the lexicon of both English and Standard Arabic (SA), applying it procedurally to test its scope of functionality crosslinguistically, and singling out the closest noun synonymous equivalents among the membership of the two sets in this particular lexical semantic field in both languages. The componential analysis and the matching procedures carried have been functional in identifying ten totally matching equivalents (i.e. at 55.6%), and eight partially matching ones (i.e. at %44.4%). This result shows that while total matching equivalences do exist in the translation of certain Eng
... Show MoreThe higher education has become an enterprise integrate system that described as knowledge society, the essential part in its electronic and virtual format in the shadow of globalization challenges with its various dimensions . Until the logical ryles aboat a strategic partnership between the Iraqi higher education establishments and their international equivalent ones Strategic windows should be invested for the purpose of enhancing the quality of higher education in a sustainable way. This forms a challenge before the international education leaders on the social, operational and establishment's level to determinte knowledge gap, observing, diagnosing and processing in the present and future, e
... Show MoreIncreasing world demand for renewable energy resources as wind energy was one of the goals behind research optimization of energy production from wind farms. Wake is one of the important phenomena in this field. This paper focuses on understanding the effect of angle of attack (α) on wake characteristics behind single horizontal axis wind turbines (HAWT). This was done by design three rotors different from each other in value of α used in the rotor design process. Values of α were (4.8˚,9.5˚,19˚). The numerical simulations were conducted using Ansys Workbench 19- Fluent code; the used turbulence model was (k-ω SST). The results showed that best value for extracted wind energy was at α=19˚, spread distance of wak
... Show MoreThe use analysis value chain such information in the provision as financial so information quality meet and satisfy the needs of users such information , particularly investors and lenders as the identification needs financial information and the knowledge as their behavior influenced by that information can be based on the accounting profession to focus on improving their function in order to achieve its goal that satisfying their needs and rationalize their decisions . In accounting thought discovered fertile ground for users preferences as one of the entrances theorising positive which is based on the need to include knowledge on accounting hypothesis that explain the
... Show MoreThe biggest problem of structural materials for fusion reactor is the damage caused by the fusion product neutrons to the structural material. If this problem is overcomed, an important milestone will be left behind in fusion energy. One of the important problems of the structural material is that nuclei forming the structural material interacting with fusion neutrons are transmuted to stable or radioactive nuclei via (n, x) (x; alpha, proton, gamma etc.) reactions. In particular, the concentration of helium gas in the structural material increases through deuteron- tritium (D-T) and (n, α) reactions, and this increase significantly changes the microstructure and the properties of the structural materials. T
... Show MoreA Simple, rapid and sensitive extractive and spectrophotometric method has been described for the analysis of diphenhyldramine –HCl (DPH) in pure form and in pharmaceutical formulations. The method is based on the formation of chloroform soluble ion-pair complex with Bromophenol blue(BPB) in a phthalate buffer at pH 3.0.The extracted complex shows maximum absorbance at 410 nm. Beer's law is obeyed in the concentration range 0.2-25.0 µg.ml-1. The molar absorptivity and Sandell's sensitivity for the system being 2.416x104 L.mol-1.cm-1 and 0.012µg.cm-2, respectively. The limit of detection was found to be 0.155 µg.ml-1. The proposed me
... Show MoreThe aim of this research is to identify the level of mental mindfulness among female students of the College of Education at Umm Al-Qura University, as well as to identify the statistically significant differences in the level of mental mindfulness according to academic level, specialization, and academic achievement. A mental mindfulness scale was designed to cover five dimensions. The study employed the analytic descriptive approach applied to a random sample of (217) female students from various academic specializations. The findings indicated that the level of mental mindfulness was average among female students. Statistically significant differences were attributable to the academic level, academic specializations, and academic achi
... Show MoreSelf-compacted concrete (SCC) considered as a revolution progress in concrete technology due to its ability for flowing through forms, fusion with reinforcement, compact itself by its weight without using vibrators and economic advantages. This research aims to assess the fresh properties of SCC and study their effect on its compressive strength using different grading zones and different fineness modulus (F.M) of fine aggregate. The fineness modulus used in this study was (2.73, 2.82,2.9& 3.12) for different zones of grading (zone I, zone II& marginal zone(between zone I&II)) according to Iraqi standards (I.Q.S No.45/1984).Twelve mixes were prepared, each mix were tested in fresh state with slump, V-Funnel and L-Box tests, t
... Show MoreObjective(s): The present study aims to evaluate the effectiveness of Health educational program on nurses' knowledge toward children pneumonia at Al-Amara City hospitals..
Methodology: A quasi –experimental study design two-study group (pretest-posttest 1 and posttest 2) carried out at Alzahrawy Hospital and Child and maternity hospital in Al Amara City to identify the effectiveness of the Health educational program on Nurses Knowledge toward Children pneumonia; the study was conducted between 1 of September 2019 to 1 of April 2020. A Purposive (Non-probability) sample is chosen for the present study. The size of sample is (60) nurses divided into two gr
... Show MoreIn this paper, we study a new concept of fuzzy sub-module, called fuzzy socle semi-prime sub-module that is a generalization the concept of semi-prime fuzzy sub-module and fuzzy of approximately semi-prime sub-module in the ordinary sense. This leads us to introduce level property which studies the relation between the ordinary and fuzzy sense of approximately semi-prime sub-module. Also, some of its characteristics and notions such as the intersection, image and external direct sum of fuzzy socle semi-prime sub-modules are introduced. Furthermore, the relation between the fuzzy socle semi-prime sub-module and other types of fuzzy sub-module presented.