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.
A genetic algorithm model coupled with artificial neural network model was developed to find the optimal values of upstream, downstream cutoff lengths, length of floor and length of downstream protection required for a hydraulic structure. These were obtained for a given maximum difference head, depth of impervious layer and degree of anisotropy. The objective function to be minimized was the cost function with relative cost coefficients for the different dimensions obtained. Constraints used were those that satisfy a factor of safety of 2 against uplift pressure failure and 3 against piping failure.
Different cases reaching 1200 were modeled and analyzed using geo-studio modeling, with different values of input variables. The soil wa
The study presents the test results of Completely Decomposed Granite (CDG) soil tested under drained triaxial compression, direct shear and simple shear tests. Special attention was focused on the modification of the upper halve of conventional Direct Shear Test (DST) to behave as free
head in movement along with vertical strain control during shear stage by using Geotechnical Digital System (GDS). The results show that Free Direct Shear Test (FDST) has clear effect on the measured shear stress and vertical strain during the test. It has been found that shear strength
parameters measured from FDST were closer to those measured from simple shear and drained triaxial compression test. This study also provides an independent check on
In the era of the digital economy, public organizations need to consolidation the capabilities of entrepreneurial alertness to reduce the risks of sudden transformations and changes, and to find effective mechanisms to discover and invest in environmental opportunities proactively, as this concern has become a knowledge gap in public sector institutions, the current research aims to identify the role of digital competence in influencing on entrepreneurial alertness in the Central Bank of Iraq (CBI), the descriptive analytical approach was used as a research method to describe and analyze the main research variables. digital competence as an explanatory variable includes three dimensions: digital infrastructure, digital integration, and d
... Show MoreIn regression testing, Test case prioritization (TCP) is a technique to arrange all the available test cases. TCP techniques can improve fault detection performance which is measured by the average percentage of fault detection (APFD). History-based TCP is one of the TCP techniques that consider the history of past data to prioritize test cases. The issue of equal priority allocation to test cases is a common problem for most TCP techniques. However, this problem has not been explored in history-based TCP techniques. To solve this problem in regression testing, most of the researchers resort to random sorting of test cases. This study aims to investigate equal priority in history-based TCP techniques. The first objective is to implement
... Show MoreThe aim of the research to apply TD-ABC technology to determine the idle capacity of the central oil companies (oil field east of Baghdad), as a modern cost management technology based on time-oriented activities (TD-ABC) is used by industrial companies in general and oil companies on In particular to build a sustainable Calvinist pillar and make future decisions by identifying idle energy to gain it a competitive advantage, the descriptive analytical approach has been adopted in calculating and analyzing the company’s data for 2018, and the most prominent conclusions of this research are managing idle energy and the task of applying cost technology on the basis of time-oriented activities and providing Convenient spatial infor
... Show MoreThe effect of the tensor term in the Skyrme interaction has been estimated in calculating the static and dynamic nuclear properties in sd and fp-shell model spaces nuclei. The nuclear shell gaps have been studied with different Skyrme parameterizations; Skxta and Skxtb with tensor interaction, SkX, SkM, and SLy4 without tensor interaction, and Skxcsb with consideration of the effect of charge symmetry breaking. We have examined the stability of N = 28 for 42Si and 48Ca. The results showed that the disappearance of the magicity occurs in the shell closure of 42Si. Furthermore, excitation energy, quadrupole deformation, neutron separation energy, pairing energy, and density profile have also been calculated. Quadrupole deformation indicates a
... Show MoreOne of the main techniques to achieve phase behavior calculations of reservoir fluids is the equation of state. Soave - Redlich - Kwong equation of state can then be used to predict the phase behavior of the petroleum fluids by treating it as a multi-components system of pure and pseudo-components. The use of Soave – Redlich – Kwon equation of state is popular in the calculations of petroleum engineering therefore many researchers used it to perform phase behavior analysis for reservoir fluids (Wang and Orr (2000), Ertekin and Obut (2003), Hasan (2004) and Haghtalab (2011))
This paper presents a new flash model for reservoir fluids in gas – oil se
There is no doubt that the achievement of the manuscripts of There is no doubt various of situations for performing a duty , The diversity of stimuli in humans with sensory, unconscious and instinct sensitive systems. Which leads to a diversity of feelings, sensations, emotions and feelings, This therefore requires different types of function linguistic structures indication , Of that linguistic potential that God willing to be unique, In the function of discharging and venting those feelings and emotions that are raised by its various stimuli, which are only needs and psychological and biological purposes require verification and access and gain it. S
... Show MoreThe current study seeks to evaluate teacher preparation programs in the scientific disciplines at the College of Education in Al-Aqsa University in the light of the requirements of the labor market. It further aims to reveal the significance of the differences in the sample members’ response averages of to the availability of labor market requirements in the program that prepares the teacher of scientific disciplines at the Faculty of Education in Al-Aqsa University taking into account the (gender, program) variables. The study followed the descriptive analytical approach, and so a questionnaire was distributed to a sample of scientific discipline students in the teacher preparation program adopted in Al-Aqsa University, (200) male and
... Show MorePurpose: The purpose of this study was to clarify the basic dimensions, which seeks to indestructible scenarios practices within the organization, as a final result from the use of this philosophy.
Methodology: The methodology that focuses adoption researchers to study survey of major literature that dealt with this subject in order to provide a conceptual theoretical conception of scenarios theory .
The most prominent findings: The only successful formulation of scenarios, when you reach the decision-maker's mind wa takes aim to form a correct mental models, which appear in the expansion of Perception managers, and adopted as the basis of the decisions taken. The strength l
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