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 current research aims to recognize the exploratory and confirmatory factorial structure of the test-wiseness scale on a sample of Hama University students, using the descriptive method. Thus, the sample consists of (472) male and female students from the faculties of the University of Hama. Besides, Abu Hashem’s 50 item test-wiseness scale (2008) has been used. The validity and reliability of the items of the scale have also been verified, and six items have been deleted accordingly. The results of the exploratory factor analysis of the first degree have shown the presence of the following five acceptable factors: (exam preparation, test time management, question paper handling, answer sheet handling, and revision). Moreover,
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Lead-acid batteries have been used increasingly in recent years in solar power systems, especially in homes and small businesses, due to their cheapness and advanced development in manufacturing them. However, these batteries have low voltages and low capacities, to increase voltage and capacities, they need to be connected in series and parallel. Whether they are connected in series or parallel, their voltages and capacities must be equal otherwise the quality of service will be degraded. The fact that these different voltages are inherent in their manufacturing, but these unbalanced voltages can be controlled. Using a switched capacitor is a method that was used in many methods for balancing voltages, but their respons
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The erythrocyte aggregation is an important physiological phenomenon in the circulation of blood. It is a basic characteristic of normal blood that plays a major role in the cardiovascular system, especially in the microcirculation. This study explained the kinetics of single cells rouleaux formation one- dimensional aggregate and three- dimensional aggregate, during simultaneous, and the effect of hematocrit on the process of aggregation and sedimentation. The present study was done on forty one healthy subjects. Laser light is passed through a well mixed sample of blood and the forward scattered light intensities recorded continuously. The samples were prepared with different hematocrit, (10%, 15%, 20%, and 25%). Increasing
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This study is an approach to assign the land area of Kirkuk city [ a city located in the northern of Iraq, 236 kilometers north of Baghdad and 83 kilometers south of Erbil [ Climatic atlas of Iraq, 1941-1970 ] into different multi zones by using Satellite image and Arc Map10.3, zones of different traffic noise pollutions. Land zonings process like what achieved in this paper will help and of it’s of a high interest point for the future of Kirkuk city especially urban
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إنّ التّأمّل في الدّراسات الأدبيّة النّقديّة الحديثة الّتي تنظر إلى النّصّ أنّه لوحة تتشكّل من مجموعة تداخلات نصّيّة سابقة للنصّ المُنتج أو مُعاصرة له، تدفع القارئ إلى الغوص في أعماق النّصوص وتحليلها والكشف عن الآليّات والإجراءات الّتي اعتمدت في إنتاجه، وإظهار الجماليّات الفنّيّة التي شكلت في مُجملها كائنا حيّا يُعبّر عن حالات إنسانيّة مُستمرة الحدوث رغم تقادم الأزمان.
فالبحث هذا يعمد
... Show MoreThe influence of culture on accounting systems and practices, including financial reports and accounting information through the values identified by Gray and derived from social-cultural values, and the four accounting values were derived from generally accepted accounting principles represented by (Conservatism, Uniformity, Secrecy, and Professionalism). Important and significant in maximizing financial performance, and measuring the extent of the role of these values in improving financial performance through attention to the values of accounting culture, this research
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This research is a critical methodological study deals with some Quranic verses abrogative,abrogated.
by Ibn al-Jawzi (may Allah have mercy on him) in his book (Tafseer Zad al-Maseer) inin Surah Al-Baqara the in the holy Quraan.
The objective of the present study is to determine the effect of Kaolin as a fuel oil additive to minimize the fireside corrosion of superheater boiler tubes of ASTM designation (A213-T22) by increasing the melting point of the formed slag on the outside tubes surface, through the formation of new compounds with protective properties to the metal surface. The study included measuring corrosion rates at different temperatures with and without additive use with various periods of time, through crucible test method and weight loss technique.
A mathematical model represents the relation between corrosion rate and the studied variables, is obtained using statistical regression analysis. Using this model,
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The objective of this research is to study the possibility of reducing the reflectivity of the front surface of a silicon cell (Si / Si) by using a theoretical design for a single-layer Antireflection Coatings with a thickness of one quarter of the design wavelength. Then, Mathematical programs in MATLAB (10) were designed to study the quantitative efficiency of the cell as a function of the change in the particle size of the coating within the range (400 - 700 nm) wavelength of the visible state of the vertical and oblique state at the (45°) angle. (Ge) was used as an anti-reflective material. It was found that the highest quantitative efficiency was (96.9004%) at design wavelength (λ0= 550 nm)
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