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 research problem lies in the ambiguity of the usage of propaganda contents by two main media outlets (the Russian RT and American Alhurra) in their news coverage of the Syrian crisis through their websites and the methods used by them to convince users taking into account the mutual propaganda conflict between the United States and Russia in the war against Syria. The objectives of the research can be represented by the following: investigating the contents of American and Russian electronic propaganda towards Syrian crisis.
• Identifying the contents that received most of the coverage in the Syrian crisis by the two news outlets.
• Identifying the terms and phrases that have been most used by the websites of RT and Alhurr
Abstract
This research aims to design a multi-objective mathematical model to assess the project quality based on three criteria: time, cost and performance. This model has been applied in one of the major projects formations of the Saad Public Company which enables to completion the project on time at an additional cost that would be within the estimated budget with a satisfactory level of the performance which match with consumer requirements. The problem of research is to ensure that the project is completed with the required quality Is subject to constraints, such as time, cost and performance, so this requires prioritizing multiple goals. The project
... Show More
Abstract
In this paper, fatigue damage accumulation were studied using many methods i.e.Corton-Dalon (CD),Corton-Dalon-Marsh(CDM), new non-linear model and experimental method. The prediction of fatigue lifetimes based on the two classical methods, Corton-Dalon (CD)andCorton-Dalon-Marsh (CDM), are uneconomic and non-conservative respectively. However satisfactory predictions were obtained by applying the proposed non-linear model (present model) for medium carbon steel compared with experimental work. Many shortcomings of the two classical methods are related to their inability to take into account the surface treatment effect as shot peening. It is clear that the new model shows that a much better and cons
... Show MoreThe efficient removal of dissolved organic compounds (DOC) from wastewater has become a major environmental concern because of its high toxicity even at low concentrations. Therefore, a technique was needed to reduce these pollutants. Ion exchange technology (IE) was used with AmberliteTM IR120 Na, AmberliteTM IR96RF, and AmberliteTM IR402, firstly by using anion and mixed bed system, where the following variables are investigated for the process of adsorption: The height of the bed in column (8,10 and 14 cm), different concentrations of (DOC) content at constant flow rate. The use of an ion exchanger unit (continuous system) with three columns (cation, anion, and mixed bed) was studied.
... Show More
(2)
In this work, a chemical optical fiber sensor based on Surface Plasmon Resonance (SPR) was designed and implemented using plastic optical fiber. The sensor is used for estimating refractive indices and concentrations of various chemical materials (methanol, distilled water, ethanol, kerosene) as well as for evaluating the performance parameters such as sensitivity, signal to noise ratio, resolution and the figure of merit of the fabricated sensor. It was found that the value of the sensitivity of the optical fiber-based SPR sensor, with 40 nm thick and 10 mm long Au metal film of exposed sensing region, was 3μm/RIU, while the SNR was 0.24, the figure of merit was 20, and the resolution was 0.00066. The sort of optical fiber utilized i
... Show More
(17)
(11)
Clinicians and investigators consider the normal range of bowel habit and frequency as between 3 to 21 motions per week. Stool frequency outside the normal range may be unusual but may not be abnormal in the sense of a disease, and according to the consistency, the normal stool ranges from porridge like to hard and pellety.
Objectives: To establish a basic data about the bowel habits (consistency and frequency) in a sample of healthy Iraqi population; in addition to learn about their definition of constipation and diarrhea.
Methods: Prospective study from Jan 2000- Jun 2000 at Al-Yarmouk teaching hospital, Baghdad. Questionnaires were distributed to 950 healthy persons of different age group .The questionnaire included: Detailed hi
Background: Clinicians and investigators consider the normal range of bowel habit and frequency as between 3 to 21 motions per week . Stool frequency out side the normal range may be unusual but may not be abnormal in the sense of a disease . And according to the consistency, the normal stool ranges from porridge like to hard and pellety .Objectives: To establish a basic data about the bowel habits (consistency and frequency) in a sample of healthy Iraqi population; in addition to learn about their definition of constipation and diarrhea.Methods: Prospective study from Jan 2000- Jun 2000 at Al-Yarmouk teaching hospital, Baghdad. Questionnaires were distributed to 950 healthy persons of different age group .The questionnaire included: Det
... Show MoreThis paper presents the implementation of a complex fractional order proportional integral derivative (CPID) and a real fractional order PID (RPID) controllers. The analysis and design of both controllers were carried out in a previous work done by the author, where the design specifications were classified into easy (case 1) and hard (case 2) design specifications. The main contribution of this paper is combining CRONE approximation and linear phase CRONE approximation to implement the CPID controller. The designed controllers-RPID and CPID-are implemented to control flowing water with low pressure circuit, which is a first order plus dead time system. Simulation results demonstrate that while the implemented RPID controller fails to stabi
... Show MoreIntersectionality is a concept that focuses on social inequality towards black people and provides an analytical instruments for creating social justice issues in such a way in order to depict how social marginalization, or privilege occurs differently in various social positions. It does this by focusing on the interaction of multiple systems of oppression. Intersectionality is used to examines how the social factors; race, gender, and class can affect the people’s life especially the immigrants, black people, and refuges. This article will depicts how blacks in Canada are segregated and distinguished from white race. David Chariandy’s I’ve Been Meaning To Tell You: A Letter to My Daughter 2018 is analyzed through Kimberle Crenshaw
... Show MoreIntersectionality is a concept that focuses on social inequality towards black people and provides an analytical instruments for creating social justice issues in such a way in order to depict how social marginalization, or privilege occurs differently in various social positions. It does this by focusing on the interaction of multiple systems of oppression. Intersectionality is used to examines how the social factors; race, gender, and class can affect the people’s life especially the immigrants, black people, and refuges. This article will depicts how blacks in Canada are segregated and distinguished from white race. David Chariandy’s I’ve Been Meaning To Tell You: A Letter to My Daughter 2018 is analyzed through Kimberle Crenshaw
... Show More