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 Dagum Regression Model, introduced to address limitations in traditional econometric models, provides enhanced flexibility for analyzing data characterized by heavy tails and asymmetry, which is common in income and wealth distributions. This paper develops and applies the Dagum model, demonstrating its advantages over other distributions such as the Log-Normal and Gamma distributions. The model's parameters are estimated using Maximum Likelihood Estimation (MLE) and the Method of Moments (MoM). A simulation study evaluates both methods' performance across various sample sizes, showing that MoM tends to offer more robust and precise estimates, particularly in small samples. These findings provide valuable insights into the ana
... Show Morethe researchers Sought to determine the impact of the customer contact (Within a client contact there are two times, first is the total time required to create a service and within it there is contact time while the second time is the time of client contact ؛ where means a time that records the physical presence of the customer during the process of service) on operations performance by concentrate attention on the cost (labor productivity) and quality (patient ratio to the doctor) and speed (cycle time) and flexibility (the flexibility range) , as well as ruling out variable of innovation because of impossibility to measure this variable in the Specialty Center for Dental in al-alwia due to the center is lacking of mechanisms t
... Show MoreThis research aims to measure the productivity of nursing services and recognize the reality of providing such services in some public hospitals in the province of Diyala, as well as identify the most important factors affecting the productivity of nursing services, and developer measure adopted by the researcher (Kien, 2012), which includes seven factors (workforce , management team, stimulation, pressure of working hours (time), material / equipment, supervision, safety), Used the experimental method in the search, one of the private scientific research curriculum depends primarily on the scientific experiment and study of the subject, or a scientific phenomenon, which provides an opportunity to learn the facts
... Show MoreAn image retrieval system is a computer system for browsing, looking and recovering pictures from a huge database of advanced pictures. The objective of Content-Based Image Retrieval (CBIR) methods is essentially to extract, from large (image) databases, a specified number of images similar in visual and semantic content to a so-called query image. The researchers were developing a new mechanism to retrieval systems which is mainly based on two procedures. The first procedure relies on extract the statistical feature of both original, traditional image by using the histogram and statistical characteristics (mean, standard deviation). The second procedure relies on the T-
... Show MoreThe process of evaluating business processes, complex, repetition of procurement processes, need for raw materials and frequency of demand, which makes dealing with suppliers in the evaluation process, making the need for a process intervention in the process. Lighter on the other hand.
Many Iraqi companies suffer from problems related to suppliers, and cases of administrative and financial corruption are often raised regarding this type of contract and from this reality the necessity of researching this problem and trying to develop some solutions to reduce its impact on the companies' work, by using a method that works according to the standards adopted in Evaluation and selection of the supplier in the
... Show MoreThe aim of this study is to achieve the best distinguishing function of the variables which have common characteristics to distinguish between the groups in order to identify the situation of the governorates that suffer from the problem of deprivation. This allows the parties concerned and the regulatory authorities to intervene to take corrective measures. The main indicators of the deprivation index included (education, health, infrastructure, housing, protection) were based on 2010 data available in the Central Bureau of Statistics
The aim of the research is to identify the impact of the dimensions of the European Excellence Model in evaluating the performance of the bank of the research sample, as well as to interpret which dimensions are more important to the banks of the research sample. Based on the dimensions of this model, the United Bank for Investment and Finance has chosen a research community, and has met with officials of the United Bank for Investment and Finance at various administrative levels to measure the practices of excellence management in the European model, and the analytical approach has been the case study and the construction of the checklist as a tool to collect information. The research has reached the most important results There is a discr
... Show MoreThe current research aims to determine the requirements of Trends of International Mathematics and Science Study (TIMSS 2019) and to find out the extent to which the content of science textbooks for grades (1-4) in the Sultanate of Oman includes the requirements of (TIMSS 2019). Only the content dimension has been taken into account when conducting the content analysis. The study population includes all science books from the first to the fourth grade for the academic year 2021-2022. The study identified and organized the requirements in the study tool, which is a list of requirements of (TIMSS 2019). The results showed a general deficiency in all grades (1-4) in the content dimension including many main topics, subtopics, and objectives
... Show MoreTransparent nano- coating was prepared by Sol-Gel method from titanium dioxide TiO2 which has the ability to self-cleaning coating used for hospitals, laboratories, and places requiring permanent sterilization. Three primary colors are selected (red, blue, and yellow) as preliminary study to the effect of these colors on the nano-coating. Three traditional oil paints color were used as base, then coated by a layer of TiO2-Sol and deposited on the paints. The optical properties of TiO2-Sol were measured; the maximum absorption wavelength at (λmax=387 nm), the refractive index (n=1.4423) and the energy band gap (Eg=3.2 eV). The structure properties found by X-ray diffraction of TiO
Objective: 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