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.
New types of hydrodesulfurization (HDS) catalyst Re-Ni-Mo/ γ-Al2O3 was prepared and tested separately with two prepared conventional HDS catalysts (Ni-Mo/ γ-Al2O3 and Co-Mo//γ-Al2O3) by using a pilot plant hydrotreatment unit. Activities of three prepared hydrodesulfurization catalysts were examined in hydrodesulfurization (HDS) of atmospheric gas oil at different temperatures 275 to 350 °C and LHSV 1 to 4 h-1, the reactions conducted under constant pressure 40 bar and H2/HC ratio 500 ml/ml .Moreover, the hydrogenation of aromatic (HAD) in gas oil has been studied. HDS was much improved by adding promoter Re to the Ni-Mo/Al2O3
... Show MoreBackground: The treatment of an ovarian cyst relies on its nature, the discrimination of benign and malignant cysts is, therefore of crucial importance, and in spite of the continuous improvement of diagnostic means, it remains sometimes impossible to differentiate functional from organic (malignant or not) ovarian cysts. The therapeutic decision will search for the main midway between cancer’s negligence and the fear of performing an unnecessary surgical operation for an ovarian cyst.Objective: To review of 116 cases of ovarian cystic diseases aiming in identify proper management and reducing unnecessary surgical intervention.Methods: A retrospective study was conducted at Al-Elwiya maternity teaching hospital/ Baghdad/ Iraq. One hund
... Show MoreThe development of human resources training programs has an applied and important role in the preparation of human cadresin terms of capacity to absorb technical sciences and skills and scientific and practical practices at faster rates in order to bealighed with continous development. Hence the recognition of the significant role that human resources play in the economy of any country,which has stressed the interest towards the economic unity of the qualified staff that it needsin atimely manner through the ongoing training process in the era of high technology day by day In this regard ,the current research deal with accounting of human resources and its impact on reducing costs in the military establishment and the
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At present, smooth movement on the roads is a matter which is needed for each user. Many roads, especially in urban areas geometrically improved because of the number of vehicles increase from time to time.
In this research, Highway capacity software, HCS, 2000, will be adopted to determine the effectiveness of roundabout in terms of capacity of roundabout, delay and level of service of roundabout.
The results of the analysis indicated that the Ahmed Urabi roundabout operates under level of service F with an average control delay of 300 seconds per vehicle during the peak hours.
The through movements of Alkarrada- Aljadiriya direction (Major Direction) represent the heaviest traff
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The duration of the contract is a legal term first provided for in French Amendment Decree No. 131/2016, and given the increasing importance of time in contracts, we have chosen to study the legal rules governing time at the formative stage by drawing on changes in French law compared to both Iraqi and Egyptian laws. Article 1102 of French Amendment Decree No. 131/2016 stipulates that: "Everyone is free to contract or not to contract, to choose the person with whom he contracts, and to determine the content and form of the contract within the limits established by law." Contractual freedom does not permit a breach of the rules relating to public order), as well as article 1104, which provides for (contracts must be nego
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The settlement rate and pore water pressure dissipation rate are mainly controlled by the permeability of soil. Both laboratory and field tests show that the permeability is varied during the loading and consolidation process. It is known that consolidation process is accompanied by decrease in void ratio which leads to decrease in the coefficient of permeability. The importance of the decrease of the coefficient of permeability on the time rate of settlement and pore water pressure needs to be investigated.
This paper takes into account the change in coefficient of permeability during consolidation and studies its effect on consolidation characteristics of a clay layer. The finite element method is used in the analysis and the packag
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Abstract
This research aims to identify the availability of the elements of the concept of citizenship, to identify the distribution ratios of the outputs of the musical skills curriculum at the levels of educational goals associated with the elements of the concept of citizenship in the guides of teachers of musical skills for grades (12-1) in the Sultanate of Oman. A content analysis card was designed to include the teacher’s guides of musical skills for grades (12-1), which included the outputs, according to the grades with the identification of the elements of citizenship (identity, belonging, rights, participation). The results of the research revealed that the percentage of inclusion of citizenship values
... Show MoreSince her early beginning in 1974 in her novel "Les armoires vides", Annie Ernaux writing about life in all its various aspects remained her main goal. This novel gave the earliest signals of what would happen later on in her literary career. Indeed, her works showed abilities of echoing reality, her sufferance and experiences via the use of simple and clear language. Add to this, her writings are to be viewed as an expression of deep felt journey, and a continuous search due to the consequent changes coming out of her identity.
We try here to give an answer to the question about writing as to whether being, to Ernaux herself, a need for the search about her social and feminist identity, or a pure literary work
... Show MoreIn this study, the effect of the combination of micro steel fibers and additives (calcium hydroxide and sodium carbonate) on the size of cracks formation and healing them were investigated. This study aims to apply the use of self-healing phenomenon to repair cracks and to enhance the service life of the concrete structures. Micro steel fibers straight type were used in this research with 0.2% and 0.4% by volume of concrete. A weight of 20 and 30 kg/m3 of Ca(OH)2 and 2 and 3 kg/m3 of Na2CO3 were used as a partial cement replacement. The results confirm that the concrete cracks were significantly self-healed up to 30 days re-curing. Cracks width up to 0.2 mm were comp
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