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.
ANN modeling is used here to predict missing monthly precipitation data in one station of the eight weather stations network in Sulaimani Governorate. Eight models were developed, one for each station as for prediction. The accuracy of prediction obtain is excellent with correlation coefficients between the predicted and the measured values of monthly precipitation ranged from (90% to 97.2%). The eight ANN models are found after many trials for each station and those with the highest correlation coefficient were selected. All the ANN models are found to have a hyperbolic tangent and identity activation functions for the hidden and output layers respectively, with learning rate of (0.4) and momentum term of (0.9), but with different data
... Show MoreIn this paper waste natural material (date seed) and polymer particles(UF) were used for investigation of removal dye of the potassium permanganate. Also study effect some variables such as pH, dye concentration and adsorbent concentration on dye removal. 15 experimental runs were done using the itemized conditions designed established on the Box-Wilson design employed to optimize dye removal. The optimum conditions for the dye removal were found: (pH) 12, (dye con.) 2.38 ppm, (adsorbant con.) 0.0816 gm for date seed with 95.22% removal and for UF (pH) 12, (dye con.) 18 ppm, (adsorbant con.) 0.2235 gm with 91.43%. The value of R-square was 85.47% for Date seed and (88.77%) for UF.
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A New Spectrophotometric Methods are improved for determination Metronidazole (MTZ) and Metronidazolebenzoate (MTZB) depending on1STand 2nd derivative spectrum of the two drugs by using ethanol as a solvent. Many techniques were proportionated with concentration (peak high to base line, peak to peak and peak area). The linearity of the methodsranged between(1-25µg.ml-1) is obtained. The results were precise and accurate throw RSD% were between (0.041-0.751%) and (0.0331-0.452%), Rec% values between (97.78, 101.87%) and (98.033-102.39%) while the LOD between (0.051-0.231 µg.ml-1) and (0.074-1.04 µg.ml-1) and LOQ between (0.170-0.770µg.ml-1) and (0.074-0.313 µg.ml-1) of (MTZ) and of (MTZB) respectively. These Methods were successfully ap
... Show MoreA character is one of the most important pillars of narrative production. Most critics believe that a character is the focus of events.
Jacob Steinberg, a Jewish writer who is Ukrainian by origin, wrote many stories, most of which spoke about the lives of Jews in the diaspora, especially in Ukraine. The environment there has been reflected in his stories.
Steinberg focused on the role of characters in shaping these productions.
In this study, we discuss the conflict of characters in Steinberg's stories. This conflict is characterized by different trends and goals. There is a conflict with the environment, a conflict with society, a conflict with the self,
... Show MoreBackground: The beneficial gut bacterium E. coli can cause blood poisoning, diarrhoea, and other gastrointestinal and systemic disorders. Objective: This study amid to examines the antibiofilm activity of Laurus nobilis leaves extract on E. coli isolates and compares pre- and post-treatment gene expression of fimA and papC genes. Subjects and Methods: Ten isolates of E. coli were obtained from the Genetic Engineering and Biotechnology Institute, University of Baghdad, which was previously collected from Baghdad city hospitals and diagnosed by chemical tests, the diagnosis was confirmed using VITEK-2 System. The preparation of the aqueous and methanolic Laurus nobilis leaves extracts was done by using the maceration method and Soxhlet appara
... 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 MoreThe internationalization of the Libyan crisis and its accompanying militarization of the conflict have played a vital role in hindering to reach a comprehensive political settlement solution in Libya. The increasing international greediness in the Libyan energy resources and the geopolitical importance of the Libyan State led to the involvement of many international and regional powers in this crisis and transformed the Libyan crisis into “proxy war”. Moreover, the Turkish direct military intervention in the Libyan crisis is considered as one of the main constraints facing the international and regional efforts to settle the Libyan crisis as a result of the Turkish insistence on its military existence in Libya to preserve i
... Show MoreThe equation of Kepler is used to solve different problems associated with celestial mechanics and the dynamics of the orbit. It is an exact explanation for the movement of any two bodies in space under the effect of gravity. This equation represents the body in space in terms of polar coordinates; thus, it can also specify the time required for the body to complete its period along the orbit around another body. This paper is a review for previously published papers related to solve Kepler’s equation and eccentric anomaly. It aims to collect and assess changed iterative initial values for eccentric anomaly for forty previous years. Those initial values are tested to select the finest one based on the number of iterations, as well as the
... Show MoreThis study is aimed to Green-synthesize and characterize Al NPs from Clove (Syzygium aromaticum
L.) buds plant extract and to investigate their effect on isolated and characterized Salmonella enterica growth.
S. aromaticum buds aqueous extract was prepared from local market clove, then mixed with Aluminum nitrate
Al(NO3)3. 9 H2O, 99.9% in ¼ ratio for green-synthesizing of Al NPs. Color change was a primary confirmation
of Al NPs biosynthesis. The biosynthesized nanoparticles were identified and characterized by AFM, SEM,
EDX and UV–Visible spectrophotometer. AFM data recorded 122nm particles size and the surface roughness
RMs) of the pure S. aromaticum buds aqueous extract recorded 17.5nm particles s
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This study aims to identify the most important legislatures and legal frameworks pertaining to advertisement for children. It focuses on the western approach, which is characterized by the variety of its perspectives in presenting issues and in identifying problems. However, if studies show that there is a certain awareness about the advertisement impact on children, it is obvious that most of legislatures reject the laws restricting the broadcast advertising spots intended for children under 12 years of age, with the exception of the Swedish and the Canadian province of Quebec experiences, which opted for total ban on advertising spots broadcast messages targeting children. |