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.
Flow-production systems whose pieces are connected in a row may not have maintenance scheduling procedures fixed because problems occur at different times (electricity plants, cement plants, water desalination plants). Contemporary software and artificial intelligence (AI) technologies are used to fulfill the research objectives by developing a predictive maintenance program. The data of the fifth thermal unit of the power station for the electricity of Al Dora/Baghdad are used in this study. Three stages of research were conducted. First, missing data without temporal sequences were processed. The data were filled using time series hour after hour and the times were filled as system working hours, making the volume of the data relativel
... Show MoreBackground: Pleomorphic adenoma of the minor salivary gland is a rare benign tumor. It commonly occurs in the hard and soft palates. Treatment by surgical excision achieved success in improving the patient’s health. Objective: To evaluate the recurrence rate after surgical treatment of pleomorphic adenoma in minor salivary glands. Methods: This retrospective study included patients who attended the Maxillofacial Surgery Unit in Ghazi Al-Hariri Hospital, Baghdad, from 2019 to 2021, complaining of soft tissue lumps involving the soft and hard palate, buccal mucosa, and upper lip. After the provisional diagnosis of these lesions, a total surgical excision of the tumor with a safe margin of 1 mm was performed, and the biopsy was sent
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Abstract
This research aims to identify the relationship and the impact of the behavior of organizational citizenship in the performance of employees, as practiced behaviors organizational citizenship substantial role in achieving the objectives of both the organization and its staff at the same time, so it affects a large extent on the characteristics and performance of individuals employees and thus influence the success of the organization as a whole, problem of the research has indicated that there is a clear failure in the study of the impact of the behavior of organizational citizenship in the performance of employees, was chosen
The research work is "The passive voice as a grammatical phenomenon in four selected textbooks". The research deals with the grammatical phenomenon passive in German. The research consists of two parts, the theoretical and the empirical part. The present research work is divided into 3 sections:
The first section includes the definition of passive, passive types, process passive, state passive, passive with modal verbs, and other types of passive. The second section provides illustrations of the four selected textbooks. The third chapter presents the passive voice in textbooks, namely German language teaching for foreigners by Dora Schulz and Heinz Griesbach, Delfin von Aufderstrasse H. and others, Em von Balme, M. and others and
... Show MoreThis research aims at identifying the communicative habits and content reflections on the communication process, especially the young audience which is one of the main group for whom the announcements are made. Because young people face life with passion and aspiration making them respond to each effect used by the media in the design of the advertising using all the effective techniques, attractive methods for young children like depending on drama, technical tricks, music and logos easily to be remembered and responded to the desires of the young in their entertainment. This research also aims at identifying the impact of the internet as a channel of commercial advertising on the purchasing behavior of young people at the universities
... Show MoreReading is one of the essential components of the English language. Countries that use English as a second language (ESL) sometimes have difficulties in reading and comprehension. According to many researches, mother tongue has proved some interferences with learning a second language. This study investigated the results of reading difficulties of young second language learners in terms of accuracy, comprehension, and rate using the Neale Analysis of Reading Ability test. The study was carried out in one of the High Schools for Boys in Hyderabad, India and included Grade five, aged 10-12 years. In order to understand the reading difficulties of English as a second language, a qualitative approach was employed. Interview, reading tes
... Show MoreAn energy and exergy thermodynamic analysis using EES program was done for a domestic refrigerator working with R-134a using vapor compression refrigeration cycle. The analysis deals with the system component, i.e. compressor, condenser, evaporator and the expansion device. The analysis depends on the entropy generation minimization approach to improve the refrigerator performance by exploring the optimum design points. These design points were derived from three different theories governing the entropy generation minimization using exergy analyzing method. These theories were first applied to find the optimum balance between the hot inner condenser area and the cold inner evaporator area of the refrigerator and between
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