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 Egyptian and Iraqi schools are one of the most important musical schools in the style of playing the oud. The influence of the style of these schools extended in the contemporary Arab world, and there were important names that emerged characterized with their style of playing. Thus, the ways of tuning the strings of oud varied between the two schools because of the difference in the ways of playing and the difference in the style of expression. The aim of the research was to identify the pluralism of the variable tunings of the strings of the contemporary Arab oud of the Egyptian and Iraqi schools, along the historical period extending from the late nineteenth and twentieth centuries to the present time. The oud has been classified i
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Abstract:
Objective(s): The present study aims to evaluate the effectiveness of Health educational program on nurses' knowledge toward children pneumonia at Al-Amara City hospitals..
Methods: 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) nur
... Show MoreObjective: The aims of research to identify sample of websites of Arabian medical periodicals and exam applying to
standards for publishing on the internet.
Methodology: A survey method is applied about nine medical periodicals websites and data are collected through
forms include five international standards to assessing websites.
Results: of data collected, the following findings are obtained:
1. Through examining website addresses, unsuitability was found in using Universal Resources Locater, because six of
periodicals use com. in URL. While, all of them not relevance commercial but scientific aim.
2. To measure Credibility Standard by adopting numbers values, the results found, four of periodicals obtained (level
Increasing 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
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الملخص ان حق الملكية هو الحق الاوسع نطاقا يمنح صاحبه صلاحية ممارسة السلطات كافة ويكون محل هذه السلطات كل ما يملك الشخص سواء كان شقه او طبقة اسوة بالعقارات الاخرى كدار للسكن او ارض ، ومن اهم هذه السلطات واوسعها نطاقا ( هو سلطة التصرف ). تعد هذه السلطة جوهر حق الملكية وأخطر السلطات الممنوحة للمالك كونه بواسطتها يمكنه الاستغناء عن ملكه بأي تصرف ناقل له كالبيع أو الهبة او الوصية مثلا ، ولأهمية هذه السلط
... Show MoreBackground: Schneiderian first rank symptoms are
considered highly valuable in the diagnosis of
schneideria.
They are more evident in the acute phase of the
disorder and fading gradually with time. Many studies
have shown that the rate of these symptoms are
variable in different countries and are colored by
cultural beliefs and values.
Objectives: To find out the rate of Schneiderian first
rank symptoms among newly diagnosed schizophrenic
patients, to assess which symptom(s) might
predominate in those patients, and to find out if there
is/are any correlation(s) between the occurrence of
these symptoms and the sex of the patients.
Methods: Out of twenty-four patients with no past
psychiatric hi
The m-consecutive-k-out-of-n: F linear and circular system consists of n sequentially connected components; the components are ordered on a line or a circle; it fails if there are at least m non-overlapping runs of consecutive-k failed components. This paper proposes the reliability and failure probability functions for both linearly and circularly m-consecutive-k-out-of-n: F systems. More precisely, the failure states of the system components are separated into two collections (the working and the failure collections); where each one is defined as a collection of finite mutual disjoint classes of the system states. Illustrative example is provided.
The research aims to measure the impact of knowledge management processes individually and in total in the innovative marketing.
We depart search of a problem expressed in a number of intellectual and practical questions, the application of this research in the General Company for Vegetable Oil Industry, represented composed a sample of (63) (Director General and Deputy Director General and Director of the Department and the Division) in the company researched, it has been designed measuring instrument to collect the necessary data either statistical means they are the percentage and the arithmetic mean and standard deviation and coefficient of variation and the coefficient of simple correlation and model
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Background/objectives: To study the motion equation under all perturbations effect for Low Earth Orbit (LEO) satellite. Predicting a satellite’s orbit is an important part of mission exploration. Methodology: Using 4th order Runge–Kutta’s method this equation was integrated numerically. In this study, the accurate perturbed value of orbital elements was calculated by using sub-steps number m during one revolution, also different step numbers nnn during 400 revolutions. The predication algorithm was applied and orbital elements changing were analyzed. The satellite in LEO influences by drag more than other perturbations regardless nnn through semi-major axis and eccentricity reducing. Findings and novelty/improvement: The results demo
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