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.
Investigating the thermal and electrical gains and efficiencies influence the designed photovoltaic thermal hybrid collector (PVT) under different weather conditions. The designed system was manufactured by attaching a fabricated cooling system made of serpentine tubes to a single PV panel and connecting it to an automatic controlling system for measuring, monitoring, and simultaneously collecting the required data. A removable glass cover had been used to study the effects of glazed and unglazed PVT panel situations. The research was conducted in February (winter) and July (summer), and March for daily solar radiation effects on efficiencies. The results indicated that electrical and thermal gains increased by the incre
... Show MoreObjective: The descriptive study was used to evaluate nursing staff performance in cardiac care units at teaching
and non teaching hospitals in kirkuk city: A comparative study.
Methodology: A descriptive study was used to evaluate nursing staff performance in cardiac care units. The study
was conducted from December 29th
, 2013 up to the 27th of Apr. 2014. A non-probability (purposive) sample of
(44) nurses who work in cardiac care unit at Azady teaching Hospital and Kirkuk general Hospital was evaluated by
a questionnaire which consisted of two parts; the first part is concerned with the demographic characteristics of
the nurses and the second part concerned Observation check list for evaluation nursing staff Perfo
While the impact of the fourth Industrial Revolution on the economy keeps accelerating, the signs of the fifth industrial revolution, whose key is innovation and creativity started to evolve. However, the challenge of achieving sustainable development and its goals remains faced by the global organizations; In this situation, Islamic banks are exposed to many challenges among which is the challenge of keeping themselves abreast of the latest developments in the modern technology which in turn is a tool for continuity and competition. On the flip side, to avoid the negative impact that these changes can have such as an increased gap between financial innovations and the requirements of sustainable development. Islamic banks in the
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This research deals will the declared production planning operation in the general company of planting oils, which have great role in production operations management who had built mathematical model for correct non-linear programming according to discounting operation during raw materials or half-made materials purchasing operation which concentration of six main products by company but discount included just three products of raw materials, and there were six months taken from the 1st half of 2014 as a planning period has been chosen . Simulated annealing algorithm application on non-linear model which been more difficulty than possible solution when imposed restric
... Show MorePoly (viny1 alcohol) (PVA) of 72000 g mol -1 molar mass was cross linked through cold cast esterification with different mol % of MA and EDTA (10 % , 20 % and 30 % ), and two different mol % mixture of MA l EDTA (20 %/5% and 20%/10% .
The purpose of this study is to examine the effect of human resource diversity management practices on achieving entrepreneurship in Jordanian public universities. To achieve the aims of the study, a well-designed questionnaire was used for collecting data. The population of the study was (7433) faculty members (including different ranks such as professors, associate professors, assistant professors and lecturers) in Jordanian public universities. The study sample was selected through the use of a random sample, the questionnaire is distributed to a sample (of 400 with the percentage of 5%) selected by using a random sampling (350) copies of the questionnaire were collected, reaching about (87.5%) out of the sum total of the dist
... Show MoreIntegrating Renewable Energy (RE) into Distribution Power Networks (DPNs) is a choice for efficient and sustainable electricity. Controlling the power factor of these sources is one of the techniques employed to manage the power loss of the grid. Capacitor banks have been employed to control phantom power, improving voltage and reducing power losses for several decades. The voltage sag and the significant power losses in the Iraqi DPN make it good evidence to be a case study proving the efficiency enhancement by adjusting the RE power factor. Therefore, this paper studies a part of the Iraqi network in a windy and sunny region, the Badra-Zurbatya-11 kV feeder, in the Wasit governorate. A substation of hybrid RE sources is connected to this
... Show MoreThis study examines the vibrations produced by hydropower operations to improve embankment dam safety. This study consists of two parts: In the first part, ANSYS-CFX was used to generate a three-dimensional (3-D) finite volume (FV) model to simulate a vertical Francis turbine unit in the Mosul hydropower plant. The pressure pattern result of the turbine model was transformed into the dam body to show how the turbine unit's operation affects the dam's stability. The upstream reservoir conditions, various flow rates, and fully open inlet gates were considered. In the second part of this study, a 3-D FE Mosul dam model was simulated using an ANSYS program. The operational turbine model's water pressure pattern is conveyed t
... Show MoreThis study examined the effect of elements of internal marketing activities on customer satisfaction through an exploratory study of banking services in the city of Baghdad, if the research problem crystallized by asking a group of questions, the most important (is there a correlation and impact between the dimensions of internal marketing and customer satisfaction, this study aims to determine The effect of internal communication, training and internal market research on customer satisfaction, represented by the quality of service, loyalty and market share, and embodied the objective of this study to identify the level of availability of internal marketing activities and programs in the research banks, data were collected using
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