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 study dealt with The impact of dangerous goods Transportation for Maritime carrier responsibility, the study was exposed to the definition of dangerous goods. the study also dealt with the impact of IMDG code on the responsibility of the carrier, and the duties of the parties, as the study spotlights The duty of the carrier to prepare a compatible ship for dangerous goods transport, as well as the duty of the carrier to preserve the goods while highlighting to the difference in this obligation while transporting dangerous goods, and the study also reviewed the duties of the shipper, for example, his duty to inform the carrier with the dangerous nature of the goods and the role of IMDG code in dealing with the danger of these goods. t
... Show MoreThe current research deals with short term forecasting of demand on Blood material, and its' problem represented by increasing of forecast' errors in The National Center for Blood Transfusion because using inappropriate method of forecasting by Centers' management, represented with Naive Model. The importance of research represented by the great affect for forecasts accuracy on operational performance for health care organizations, and necessity of providing blood material with desired quantity and in suitable time. The literatures deal with subject of short term forecasting of demand with using the time series models in order to getting of accuracy results, because depending these models on data of last demand, that is being sta
... Show MoreThis study reported the investigation of the Radio Frequency (RF) signal propagation of Global System for Mobile Communications (GSM) coverage in Emmanuel Alayande College of Education (EACOED), Oyo, Oyo State, Nigeria. The study aims at amplifying the quality of service and augment end users' sensitivity of the wireless services operation. The drive test method is adopted with estimation of coverage level and received signal strength. The Network Cell Info Lite application installed in three INFINIX GSM mobile phones was employed to take the measurement of the signal strength received from the transmitting stations of different mobile networks. The results of the study revealed that MTN has the maximum signal strength with a mean value
... Show MoreIraq has the second largest proven oil reserves in the world. According to oil experts, it is expected that the Iraq's reserves to rise to 200+ billion barrels of high-grade crude.
Oil is a strategic commodity for producing and exporting countries in general, and Iraq in particular, as demonstrated by the international experience that oil is an important means to achieve economic growth, an important tool in the overall economic, social and political development. It is also an important source of hard currency for any national economy and a means to connect the local economy and the global economy. In this paper we focus our attention on selecting the best regression model that explain the effect of human capita
... Show MoreThis research (The families of martyrs, victims of terrorism, war operations and military mistakes opinion about Al- Shuhada`a Establishment ) came to know and diagnose the mental image the martyrs victims of terrorism carries about the performance of Al- Shuhada`a Establishment and the services it provides to them, and to monitor the contents of that image that they had regarding their privileges and rights that Al- Shuhada`a Establishment supposed to give it to them, according to their law. The research problem was represented by the main question: (What is the image of Al- Shuhada`a Establishment among the families of martyrs, victims of terrorism, war operations and military mistakes), and this research was classified within the d
... Show MoreThe study aimed to reveal the level of knowledge and tendencies of high- study students specializing in curriculum and teaching methods at King Khalid University towards harmonious strategies with brain-based learning (BBL). And Then, putting a proposed concept to develop knowledge and tendencies of high-study students specializing in curriculum and teaching methods at King Khalid University towards harmonious strategies with Brain-based learning (BBL). For achieving this goal, a cognitive test and a scale of tendency were prepared to apply harmonious strategies with brain-based learning. The descriptive approach was used because it suits the goals of the study. The study sample consisted of (70) male and female students of postgraduate
... Show MoreIt is necessary to use the means of recovery and other means that help to get rid of the effects of fatigue, as the game of badminton and the effectiveness of running 800 meters fall within the mixed system with the superiority of the anaerobic system by more than the air system, so requires the development of energy systems In proportion to the time of the match for badminton players and their travels and high performance and ability to tolerate the high level of lactic acid in the muscles and blood and increase the pain associated with the fatigue that occurs during the performance. In light of the physical and physiological processes of these actions N it should seek through training programs to develop your endurance and wind energy sys
... Show MoreThe complexes of Pd+2 ion with 2-(5-bromo-2-pyridylazo)-5-dieıhyl aminophenol (BPADAP) were studied kinetically and spectrophotometrically in aqueous ethanolic solutions. The reagent forms 1:1, 2:1 square planer and 1:1 bridged shape binuclear complexes with Pd+2 ion. All these complexes (violet colour) absorb light in the same region at 540, 575 and 618nm. The band at 618 nm seems to be specific for complexes of Pd+2ion with BPADAP. The rate constants of the growth in 93% H2O + 7% ethanol of 1:1 and 2:1 complexes at 575 and 618 nm were followed the first order kinetics and are quite of the same values , 0.495 and 0.463 min- 1 respectively. The rate constants of the decay of 2:1 complex
... Show MoreThe research presents the "theory of happiness according to Junaid al-Baghdadi" and the theory's most significant characteristics.
The reasons for happiness, include knowledge, love, and providence, and happiness itself is the return of man or spirit to the source from which it originated.
Geomorphology is concerned with the topographic units that make up the Earth's surface. These take many forms, such as mountains and rivers, and include many dangers such as landslides, landslides and erosion. Many studies appeared in this field to analyze its effects and risks resulting from it, including urban studies, to determine the trends of optimal urban expansion and its geomorphological interactions. The results showed that the city of Kut originated and expanded near the course of the Tigris River and its branches, and it suffers from unbalanced urban expansion, due to the high rate of population growth, and overcrowding in housing units with the growth of urban land uses in it, which prompted the city to extend horizontally and v
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