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.
In this paper the method of singular value decomposition is used to estimate the ridge parameter of ridge regression estimator which is an alternative to ordinary least squares estimator when the general linear regression model suffer from near multicollinearity.
The aim of this study was to provide an overall assessment to the efficiency of the Iraq stocks exchanges (ISE) through specifying well –known models .First, Fama's efficient market hypothesis as a contrary concept to the random walk hypothesis, was performed and it has been found that ISE follows the random process, so the price of the shares can't be predicated on the basis of past information. Second,we use a multifactor model, which so named multiple regression, to explore the link between ISE and the main economic indicators. our empirical analysis finds that every weak associations exists between major ISE measures and main economic indicators.
The paper contains a theoretical analysis of the interrelation between methodology of economics used by economic researchers and the methodology of scientific research, encouraging readers to think differently about one of the most complicated & controversial subjects.
The analysis begins with the determination of propositions that were discussed and explained in the course of the argument.
1- The economic researcher, like a scientific one, goes after the procedures of physical sciences and benefits of the forms of logic.
2- Economics deals with human behavior while the natural sciences deal with the matter.
3-This similarity a
... Show Morethe contemporary Arab scholars deal with semiotics as an approach that helps them understand the texts, its meaning, and its structural functionalism . that’s why every now and then we find some
studies and researches using semiotics as an approach in study and comparatives, some of them even used the semiotic approach in analyzing old and new texts, while others think that semiotic holds and important place in critical approaches .
even though some of them considers semiotic just a trend of fashion this really didn’t lessen the value of semiotic as a scientific and procedural approach in literary and media studies as well as in analyzing literary and journalistic texts. for this reason it is considered as an important approa
There is an increase in the need for cost accounting in all organizations and from different sectors to provide detailed information to the totals of financial accounting, first and help solve problems associated with inventory and analysis, tabulation and allocation of cost elements II and do the planning process and provide the necessary oversight and help to take the right decisions such as pricing decisions that need to Information cost accounting.
And suffer most of the non-governmental organizations from the lack of a cost accounting system provides information on the cost of service in these organizations and the department research sample circle v
Abstract:
The research aims to monitor the image of the man in the group (The Cart and the Rain) by the storyteller (Badiaa Amin); With the aim of highlighting an aspect of feminist writing, especially with regard to the relationship of women to men, and determining the form adopted by the storyteller in drawing the features of men.
The research used the descriptive-analytical method in the space of its textual formation, which aims to stand on the text and deconstruct its narrative significance. To provide a comprehensive picture of it.
Three images of the man appeared in the group's stories, represented by (the authoritarian, the negative, and the positive), and the image of the authoritarian ma
... Show MoreThe size and the concentration of the gold nanoparticles (GNPs)
synthesized in double distilled deionized water (DDDW) have been
found to be affected by the laser energy and the number of pulses.
The absorption spectra of the nanoparticles DDDW, and the
surface plasmon resonance (SPR) peaks were measured, and found to
be located between (509 and 524)nm using the UV- Vis
spectrophotometer. SPR calculations, images of transmission
electron microscope, and dynamic light scattering (DLS) method
were used to determine the size of GNPs, which found to be ranged
between (3.5 and 27) nm. The concentrations of GNPs in colloidal
solutions found to be ranged between (37 and 142) ppm, and
measured by atomic absorptio
Soft clays are generally sediments deposited by rivers, seas, or lakes. These soils are fine-grained plastic soils with appreciable clay content and are characterized by high compressibility and low shear strength. To deal with soft soil problems there is more than one method that can be used such as soil replacement, preloading, stone column, sand drains, lime stabilization and Prefabricated Vertical Drains, PVDs. A numerical modeling of PVD with vacuum pressure was analyzed to investigate the effect of this technique on the consolidation behavior of fully and different depths of partially saturated soft soils. Laboratory experiments were also conducted by using a specially-designed large consol
... Show MoreIn this study, a 3 mm thickness 7075-T6 aluminium alloy sheet was used in the friction stir welding process. Using the design of experiment to reduce the number of experiments and to obtain the optimum friction stir welding parameters by utilizing Taguchi technique based on the ultimate tensile test results. Orthogonal array of L9 (33) was used based on three numbers of the parameters and three levels for each parameter, where shoulder-workpiece interference depth (0.20, 0.25, and 0.3) mm, pin geometry (cylindrical thread flat end, cylindrical thread with 3 flat round end, cylindrical thread round end), and thread pitch (0.8, 1, and 1.2) mm) this technique executed by Minitab 17 software. The results showed th
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