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.
Seven species of semi venomous Opisthoglypha snakes (Reptilia, Ophidia) of Iraq are listed with important characteristics in morphology due to geographical and individual variation of species, as well, the confusion in the scales count of Telescopus tessellatus martini (Schmidt, 1939) of Iraq are discussed.
This paper aims to make a historical review of jet grouting techniques and encountered problems at different sites in several countries. This review is a good guide to understanding the performance and limitations of improved soils or lands. The basic concept of jet grouting technology is to use cement as a binder to accelerate the hardening process of an admixture of material grout and soil. The different case history was conducted in both sand soil and clay soil in the horizontal and vertical direction. Other papers on field construction showed that the grout can be gelled within 5-10 minutes. Due to different cases and studies, these will help improve soil by supporting the foundation load with a minimal settlement.
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Nanoparticles are defined as an organic or non-organic structure of matter in at least one of its dimensions less than 100 nm. Nanoparticles proved their effectiveness in different fields because of their unique physicochemical properties. Using nanoparticles in the power field contributes to cleaning and decreasing environmental pollution, which means it is an environmentally friendly material. It could be used in many different parts of batteries, including an anode, cathode, and electrolyte. This study reviews different types of nanoparticles used in Lithium-ion batteries by collecting the advanced techniques for applying nanotechnology in batteries. In addition, this review presents an idea about the advantages and d
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Seven species of semi venomous Opisthoglypha snakes (Reptilia, Ophidia) of Iraq are listed with important characteristics in morphology due to geographical and individual variation of species, as well, the confusion in the scales count of Telescopus tessellatus martini (Schmidt, 1939) of Iraq are discussed.
This research a mining at evaluation the efficiency of the nursing performance depended on standards of W.H.O. via application standards of W.H.O on the nursing personnel in medical city office, in light of it, it has design world evaluation list, and a sample was chosen from the nursing personnel in given researched the organization whom they are evaluated according to the standards of W.H.O for the nursing performance included of ten standards, divided in to 45 question , besides the evaluation list, the researcher get assistance of some tools of collection information via actual checking and personal interviews, a number of statistical means were used to manipulate t
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This presented study is to make comparison of cross sections to produce 71As, 72As, 73As and 74As via different reactions with particle incident energy up to 60 MeV of alpha 100 MeV of proton as a part of systematic studies on particle-induced activations on enriched Ge, Ga, Rb and Nb targets and neutron capture. Theoretical calculation of production yield, and suggestion of optimum reaction to produce 71As, 72As, 73As and 74As, based on the main published and approved experimental results of excitation functions were calculated.
Abstract
The research problem focuses on studying the interest of the Medical City Department of the Ministry of Health in improving the creative thinking skills of the administrative leadership through parallel & comprehensive thinking according to the of six thinking hats strategy. The research sample consisted of (170) administrative leaders in the upper & middle organizational levels, The questionnaire was used as a main tool for data collection, In addition to the observation & Interview, The research sought to answer the following questions: What is the extent to which the administrative leadership (Tpp & middle) in the organization investigated the concept of the six thinkin
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