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.
When scheduling rules become incapable to tackle the presence of a variety of unexpected disruptions frequently occurred in manufacturing systems, it is necessary to develop a reactive schedule which can absorb the effects of such disruptions. Such responding requires efficient strategies, policies, and methods to controlling production & maintaining high shop performance. This can be achieved through rescheduling task which defined as an essential operating function to efficiently tackle and response to uncertainties and unexpected events. The framework proposed in this study consists of rescheduling approaches, strategies, policies, and techniques, which represents a guideline for most manufacturing companies operatin
... Show MoreTransport is a problem and one of the most important mathematical methods that help in making the right decision for the transfer of goods from sources of supply to demand centers and the lowest possible costs, In this research, the mathematical model of the three-dimensional transport problem in which the transport of goods is not homogeneous was constructed. The simplex programming method was used to solve the problem of transporting the three food products (rice, oil, paste) from warehouses to the student areas in Baghdad, This model proved its efficiency in reducing the total transport costs of the three products. After the model was solved in (Winqsb) program, the results showed that the total cost of transportation is (269,
... Show MoreThe image caption is the process of adding an explicit, coherent description to the contents of the image. This is done by using the latest deep learning techniques, which include computer vision and natural language processing, to understand the contents of the image and give it an appropriate caption. Multiple datasets suitable for many applications have been proposed. The biggest challenge for researchers with natural language processing is that the datasets are incompatible with all languages. The researchers worked on translating the most famous English data sets with Google Translate to understand the content of the images in their mother tongue. In this paper, the proposed review aims to enhance the understanding o
... Show MoreThis present work is concerned with one of the syntactic issues that has been researched by many linguists, grammarians, and specialists in Islamic studies, the estimated answer to a condition. However, this topic is researched this time by examining Imam Al-Qurtbi’s opinions in interpreting related ayas from the holly Quraan in his book (Collector of Quranic Rules) or its transliteration (Al-Jami’ Li Ahkam Al-Quran). Such a step involves commenting on, tracking what Al-Qurtbi said in this regard, discussing it from the points of view of other grammarians, and judging it accordingly, taking into account the apparent surface structures of the examples collected. To achieve this objective, the inductive analytical approach has be
... Show MoreNH3 gas sensor was fabricated based on deposited of Functionalized Multi-Walled Carbon Nanotubes (MWCNTs-OH) suspension on filter paper substrates using suspension filtration method. The structural, morphological and optical properties of the MWCNTs film were characterized by XRD, AFM and FTIR techniques. XRD measurement confirmed that the structure of MWCNTs is not affected by the preparation method. The AFM images reflected highly ordered network in the form of a mat. The functional groups and types of bonding have appeared in the FTIR spectra. The fingerprint (C-C stretch) of MWCNTs appears in 1365 cm-1, and the backbone of CNTs observed at 1645 cm-1. A homemade sensi
... Show MoreLinguistic taboos exist in most cultures. Tabooed words are generally being culturespecific
and relating to bodily functions or aspects of a culture that are sacred. Such words are
avoided, considered inappropriate and loaded with affective meaning and failing to adhere to.
Strict rules, often, governing their use and lead to punishment or public shame. These taboo
words can be used as a way of violating social deixis represented by four types of honorifics;
addressee, referent, bystander, and finally setting honorifics. This paper shows how these
taboo words are used in Kenneth Bernard's play La Justice or The Cock that Crew from the
theatre of the Ridiculous as means of violating social deixis in its four types. Th
Abstract
The objective of this research is to analyze the relationship between the strategic planning for human resources and career path, and I have tested Search the Ministry of Health and some health centers headquarters in the Karkh district, that is applied in sample Consist of (45) Deputy Director, Head of Depts, Departmental Manager, and health center Manager.
Find interested in studying the two subjects are important and vital, at the level of organizations at the present time, namely the strategic planning of human resources and career path. To achieve the objectives of the research was designed Qusestionnair (31) items to collect Primary data. and collected t
... Show MoreBackground: Nutritional status during childhood is very important for individual development and growth. Nutrition has local and systemic effect on the oral health by affecting dental health and salivary composition. This study was aimed to determine effect of iron, sodium and potassium ions in saliva on the nutritional status and to determine the effect of nutritional status on caries severity among preschool children. Material and Methods: The sample consists of 90 children aged 4 and 5 years of both genders, selected from 6 kindergartens in Al-Resafa aspect of Baghdad province. Children classified according to their nutritional status into three groups (normalweight, underweight and overweight). Nutritional status was determined by usi
... Show More