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 ability of using aluminum filings which is locally solid waste was tested as a mono media in gravity rapid filter. The present study was conducted to evaluate the effect of variation of influent water turbidity (10, 20and 30 NTU); flow rate(30, 40, and 60 l/hr) and bed height (30and60)cm on the performance of aluminum filings filter media for 5 hours run time and compare it with the conventional sand filter. The results indicated that aluminum filings filter showed better performance than sand filter in the removal of turbidity and in the reduction of head loss. Results showed that the statistical model developed by the multiple linear regression was proved to be
valid, and it could be used to predict head loss in aluminum filings
Background: Economic Globalization affects work condition by increasing work stress. Chronic work stress ended with burnout syndrome.
Objectives: To estimate the prevalence of burnout syndrome and the association of job title, and violence with it among physicians in Baghdad, and to assess the burnout syndrome at patient and work levels by structured interviews.
Subjects and Methods: A cross section study was conducted on Physicians in Baghdad. Sampling was a multistage, stratified sampling to control the confounders in the design phase. A mixed qualitative and quantitative
... Show MoreGround penetrating radar (GPR) technology is used to determine the extent to which this technique can detect with a high-frequency range from 10 MHz to 1000 MHz into the ground by a transmitting antenna and A graveyard was found beneath the depth of the three meters under Surface of the earth in the shrine of the Prophet Houd and Saleh in Al-Najaf Governorate surveyed by through 4 tracks. Ground Penetrating Radar (GPR) is a device that transmits short pulses of electromagnetic energy with pulse duration about 1 ns to 20 ns. applying the filter Time- Zero to the same profile at a depth (3m) , Two types of antennas were used in this study, with two different frequencies antennas (250, 500 )MHz Three tracks (23,25,2
... Show MoreVarious visual media are becoming an increasingly important and active instrument of communication. This fact has led some political parties and leading personalities in Iraq to make use of them as an accepted forum for the discussion of public affairs usually in a manner that conforms to their declared policy. They have to draw as much popular support as they could for the causes which they fight for. As a result, a state of great confusion has been created from the contradictory statements made by the contending parties and gave left grave consequences on all types of the audience receiving them. The problem of the study can be summarized in one major question: What is the opinions of the audience as regards the statements made by the
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In the name of God, praise be to God, and prayers and peace be upon the best of God’s creation, Muhammad bin Abdullah, and upon his family and companions, and from his family:
And after:
He saw from verbs that transcend one effect if it is visual and to two effects if it is heart and this action has several strokes and it is an awareness of the sense and illusion and imagination and reason and in addition to that it has many meanings dealt with in the glossary books and as for what the verb included in the audio studies it is the explanation and deletion and slurring The heart of my place. As for what the grammatical studies included, it focuses on one or two effects according to its l
This research aims to identify the reality of teaching political science research methods curriculum, to observe practices, and differences in teaching and learning between the Arab and Western universities. Moreover, it focuses on the difficulties that face students' acquisition of the course skills. The research uses the course model of some Western and Arab universities as case study.
This research shows that the curriculum do not reach yet the final form as other political science curriculums, and its upcoming changes will reflect the needs of stakeholders. The best method to teach this curriculum is to use applied learning in groups, learning by doing, and finally problem-based learning approach. Using optimal assessment deep
... Show MoreThe objective of this research paper is two-fold. The first is a precise reading of the theoretical underpinnings of each of the strategic approaches: "Market approach" for (M. Porter), and the alternative resource-based approach (R B V), advocates for the idea that the two approaches are complementary. Secondly, we will discuss the possibility of combining the two competitive strategies: cost leadership and differentiation. Finally, we propose a consensual approach that we call "dual domination".
Many consumers of electric power have excesses in their electric power consumptions that exceed the permissible limit by the electrical power distribution stations, and then we proposed a validation approach that works intelligently by applying machine learning (ML) technology to teach electrical consumers how to properly consume without wasting energy expended. The validation approach is one of a large combination of intelligent processes related to energy consumption which is called the efficient energy consumption management (EECM) approaches, and it connected with the internet of things (IoT) technology to be linked to Google Firebase Cloud where a utility center used to check whether the consumption of the efficient energy is s
... Show MoreNearly a century and a half has passed since Sarah Orne Jewett published her much anthologized short story “A White Heron” (1886), but commentators on the tale missed one of the most important points in the text. It is the story’s similarity to the traditional Euro-centric fairy tale of “Little Red Riding Hood”. As an author, writing at the end of the ninetieth century, a time that witnessed the demise of the Romantic movement in America and the beginning of the age of Realism, Jewett did not romanticize her characters, despite the idyllic landscape in which “A White Heron” is set. Her story can be analyzed as a text that aims at disseminating ecological awareness among her young readers. This study focuses on Jewett
... Show MoreWe propose an intraguild predation ecological system consisting of a tri-trophic food web with a fear response for the basal prey and a Lotka–Volterra functional response for predation by both a specialist predator (intraguild prey) and a generalist predator (intraguild predator), which we call the superpredator. We prove the positivity, existence, uniqueness, and boundedness of solutions, determine all equilibrium points, prove global stability, determine local bifurcations, and illustrate our results with numerical simulations. An unexpected outcome of the prey's fear of its specialist predator is the potential eradication of the superpredator.