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.
An experimental study is conducted to investigate the effect of heat flux distribution on the boiling safety factor of its cooling channel. The water is allowed to flow in a horizontal circular pipe whose outlet surface is subjected to different heat flux profiles. Four types of heat flux distribution profiles are used during experiments: (constant distribution profile, type a, triangle distribution profile with its maximum in channel center, type b, triangle distribution profile with its maximum in the channel inlet, type c, and triangle distribution profile with its maximum in the channel outlet, type d). The study is conducted using heat sources of (1000 and 2665W), water flow rates of (5, 7 and 9 lit/min). The water
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Four hundred and fifty urine samples were collected from patients suffering from urinary tract infection from the General Azadi hospital in Kurkuk province ,during the period of october 2007 till march 2008 . Results of bacteriological culture revealed that (168) out of (450) studied samples (37.3%) gave positive culture using blood agar and macConkey agar ; different species of bacterial isolates were detected using morphological and biochemical tests ,from these isolates the highest percentage of the isolates were from Escherichia coli when it was (100) isolates out of (190) isolate (52.63%) . one hundred isolates were distributed between (77) from females and (23) from
... Show MoreThis research presents a new algorithm for classification the
shadow and water bodies for high-resolution satellite images (4-
meter) of Baghdad city, have been modulated the equations of the
color space components C1-C2-C3. Have been using the color space
component C3 (blue) for discriminating the shadow, and has been
used C1 (red) to detect the water bodies (river). The new technique
was successfully tested on many images of the Google earth and
Ikonos. Experimental results show that this algorithm effective to
detect all the types of the shadows with color, and also detects the
water bodies in another color. The benefit of this new technique to
discriminate between the shadows and water in fast Matlab pro
The study presents the test results of Completely Decomposed Granite (CDG) soil tested under drained triaxial compression, direct shear and simple shear tests. Special attention was focused on the modification of the upper halve of conventional Direct Shear Test (DST) to behave as free
head in movement along with vertical strain control during shear stage by using Geotechnical Digital System (GDS). The results show that Free Direct Shear Test (FDST) has clear effect on the measured shear stress and vertical strain during the test. It has been found that shear strength
parameters measured from FDST were closer to those measured from simple shear and drained triaxial compression test. This study also provides an independent check on
This research aims to identify the effective role of self-managed teams in the quality of service performance in the directorate of Ramadi municipality. The problematic nature of our research involves this main question of the effective role of self-managed teams in the Municipality of Ramadi in improving the services of performance quality to the beneficiaries from the Directorate service. The importance of this study lies in the role played by the work teams in the organizations that excel in their field, the attendant of the changes in the leadership, administrative roles of the institutions, and teams leaders, will be achieved by the self-managed teams in improving the quality of the service provided by the institution to whi
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In the era of the digital economy, public organizations need to consolidation the capabilities of entrepreneurial alertness to reduce the risks of sudden transformations and changes, and to find effective mechanisms to discover and invest in environmental opportunities proactively, as this concern has become a knowledge gap in public sector institutions, the current research aims to identify the role of digital competence in influencing on entrepreneurial alertness in the Central Bank of Iraq (CBI), the descriptive analytical approach was used as a research method to describe and analyze the main research variables. digital competence as an explanatory variable includes three dimensions: digital infrastructure, digital integration, and d
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Here, we found an estimation of best approximation of unbounded functions which satisfied weighted Lipschitz condition with respect to convex polynomial by means of weighted Totik-Ditzian modulus of continuity
An optoelectronic flow-through detector for active ingredients determination in pharmaceutical formulations is explained. Two consecutive compact photodetector’s devices operating according to light-emitting diodes-solar cells concept where the LEDs acting as a light source and solar cells for measuring the attenuated light of the incident light at 180˚ have been developed. The turbidimetric detector, fabricated of ten light-emitting diodes and five solar cells only, integrated with a glass flow cell has been easily adapted in flow injection analysis manifold system. For active ingredients determination, the developed detector was successfully utilized for the development and validation of an analytical method for warfarin determination
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In this work; copper oxide films (CuO) were fabricated by PLD. The films were analyzed by UV-VIS absorption spectra and their thickness by using profilometer. Pulsed Nd:YAG laser was used for prepared CuO thin films under O2 gas environment with varying both pulse energy and annealing temperature. The optical properties of as-grown film such as optical transmittance spectrum, refractive index and energy gap has been measured experimentally and the effects of laser pulse energy and annealing temperature on it were studied. An inverse relationship between energy gap and both annealing temperature and pulse energy was observed.
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Background: The access cavity is a critical stage in root canal therapy and it may influence the subsequent steps of the treatment. The new minimally invasive endodontic access cavity preparation concept aims to preserve sound tooth structure by conserving as much intact dentine as possible including the pulp chamber's roof, to keep the teeth from fracturing during and after endodontic treatment. While there is great interest in such access opening designs in numerous publications, still there is a lack of scientific evidence to support the application of such modern access cavity designs in clinical practice. This review aims to critically examine the literature on minimal access cavity preparations, explain the effect of minimally inva
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