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.
Self-compacted concrete (SCC) considered as a revolution progress in concrete technology due to its ability for flowing through forms, fusion with reinforcement, compact itself by its weight without using vibrators and economic advantages. This research aims to assess the fresh properties of SCC and study their effect on its compressive strength using different grading zones and different fineness modulus (F.M) of fine aggregate. The fineness modulus used in this study was (2.73, 2.82,2.9& 3.12) for different zones of grading (zone I, zone II& marginal zone(between zone I&II)) according to Iraqi standards (I.Q.S No.45/1984).Twelve mixes were prepared, each mix were tested in fresh state with slump, V-Funnel and L-Box tests, then 72
... Show MoreThe 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
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ABSTRACT This paper has a three-pronged objective: offering a unitary set of semantic distinctive features to the analysis of nominal “hatred synonyms” in the lexicon of both English and Standard Arabic (SA), applying it procedurally to test its scope of functionality crosslinguistically, and singling out the closest noun synonymous equivalents among the membership of the two sets in this particular lexical semantic field in both languages. The componential analysis and the matching procedures carried have been functional in identifying ten totally matching equivalents (i.e. at 55.6%), and eight partially matching ones (i.e. at %44.4%). This result shows that while total matching equivalences do exist in the translation of certain Eng
... Show MoreObjective(s): The present study aims to evaluate the effectiveness of Health educational program on nurses' knowledge toward children pneumonia at Al-Amara City hospitals..
Methodology: A quasi –experimental study design two-study group (pretest-posttest 1 and posttest 2) carried out at Alzahrawy Hospital and Child and maternity hospital in Al Amara City to identify the effectiveness of the Health educational program on Nurses Knowledge toward Children pneumonia; the study was conducted between 1 of September 2019 to 1 of April 2020. A Purposive (Non-probability) sample is chosen for the present study. The size of sample is (60) nurses divided into two gr
... Show MoreThe calculation. of the nuclear. charge. density. distributions. ρ(r) and root. mean. square. radius.( RMS ) by elastic. electron. scattering. of medium. mass. nuclei. such. as (90Zr, 92Mo) based. on the model. of the modified. shell. and the use of the probability. of occupation. on the surface. orbits. of level 2p, 2s eroding. shells. and 1g gaining. shells. The occupation probabilities of these states differ noticeably from the predictions of the SSM. We have found. an improvement. in the determination. of ground. charge. density. and this improvement. allow. more precise. identification. of (CDD) between. (92Mo- 90Zr) to illustrate the influence of the extra
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A character is one of the most important pillars of narrative production. Most critics believe that a character is the focus of events.
Jacob Steinberg, a Jewish writer who is Ukrainian by origin, wrote many stories, most of which spoke about the lives of Jews in the diaspora, especially in Ukraine. The environment there has been reflected in his stories.
Steinberg focused on the role of characters in shaping these productions.
In this study, we discuss the conflict of characters in Steinberg's stories. This conflict is characterized by different trends and goals. There is a conflict with the environment, a conflict with society, a conflict with the self,
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Teaching through the system of personal learning, known as (Clare's plan) is amongst the most prominent plans which depend on self-education, as it received worldwide recognition. The plan lets the learner achieve learning by depending on himself after being familiar with the educational goals given to him, then he starts to solve the exercises and the drills accompanying the unit. After that, he checks his achievement by answering the self-evaluation tests. This method offers more opportunities for personal interaction than do the traditional systems, and individual leaning is a methodical expression aims at taking care of the learner and making him the locus of the processes of teaching and learning.
Aims of the study
... 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 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-
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