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 surgery Keywords: 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
In "historical" fiction, characters that never really existed, give expression to the impact of historical events on the people who really did live through them. The result is not history, as an accurate record of actual events, but fiction in which an earlier age is rendered through the personal joys and sufferings of characters. This paper
aims at investigating the historical realities presented in Dickens’s A Tale of Two Cities.
This research aimed at recognizing the properties of curricula that fitted to preeminent and talent students. Many types of these curricula were exposed, enrichment curriculum was explained as one of alternatives of available curricula.
The research used the analytical methodology for local and international literature in the field of preeminent and talent education to meet the properties of curricula that fitted to this special group of students. Many results was obtained as:
• This type of school enrichment curriculum consists of three levels( general discovery activities, individual and groups training activities, and individual or groups real problems).
• Investigation the effectively both sides of brain: right and left,
The 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 MoreIntroduction: Diabetic foot infections are one of the most severe complications of diabetes. This study was aimed to determine the common bacterial isolates of diabetic foot infections and the in vitro antibiotic susceptibility then treatment.
Methods: A swab was taken from the foot ulcer, and the aerobic bacteria were isolated and identified by cultural, microscopic and biochemical test, then by api-20E system. After that their antibiotic susceptibility pattern was determined. Then local and systemic treatment was used to treat the diabetic foot patients.
Results: Bacterial isolates belonging to twelve species were obtained from diabetic foot patients. Gram (-) bacteria were the predominant pathogens in the diabetic foot infection
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 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 MoreThe performance of a diesel engine was tested with diesel oil contaminated with glycol at the engineering workshop/Department of Agricultural Machines and Equipment / College of the Agricultural Engineering Sciences at the University of Baghdad. To investigate the impact of different concentrations of glycol on the performance of a diesel engine, an experimental water-cooled four-stroke motor was utilized, with oil containing 0, 100, and 200 parts per million (ppm). Specific fuel consumption, thermal efficiency, friction power, and exhaust gas temperature were examined as performance indicators. To compare the significance of the treatments, the study employed a full randomization des