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.
Administrative procedures in various organizations produce numerous crucial records and data. These
records and data are also used in other processes like customer relationship management and accounting
operations.It is incredibly challenging to use and extract valuable and meaningful information from these data
and records because they are frequently enormous and continuously growing in size and complexity.Data
mining is the act of sorting through large data sets to find patterns and relationships that might aid in the data
analysis process of resolving business issues. Using data mining techniques, enterprises can forecast future
trends and make better business decisions.The Apriori algorithm has bee
In this paper the effect of engagement length, number of teeth, amount of applied load, wave propagation time, number of cycles, and initial crack length on the principal stress distribution, velocity of crack propagation, and cyclic crack growth rate in a spline coupling subjected to cyclic torsional impact have been investigated analytically and experimentally. It was found that the stresses induced due to cyclic impact loading are higher than the stresses induced due to impact loading with high percentage depends on the number of cycles and total loading time. Also increasing the engagement length and the number of teeth reduces the principal stresses (40%) and
(25%) respectively for increasing the engagement length from (0.15 to 0
The irony pushes us to inquire about what is in the text of contradiction, irony, suspense, and other acts of paradox, as well as a departure from what is logical, or familiar, that attracts the attention of the addressee, and this is what drives us to introspect the text and interrogate it in order to get to know the intended product of the text or its real or metaphorical intent. On the other hand, the irony is more in the literary text than in the scientific texts. Therefore, critics add the word literature to it in their definition.
As it is represented by the paradox, we will seek to study the paradox of the title and the problematic that it may pose as the beginning of the text, and i
... Show MoreThis study synthesized zeolite 4A, and hierarchical composite structure consisting of zeolite 4A- carbon were successfully prepared. Hydrothermal method was used to grow a layer of zeolite 4A over porous carbon surfaces to enhance mass transfer and increase surface area of zeolite. The products then were used to remove radioactive cesium137Cs from liquid wastewater. Iraqi dates leaves midribs (DM) were used as locally available agricultural waste to prepare low- cost porous carbon, using carbonization method in tubular furnace at 900C for two hours. Hierarchical porous structures including zeolite are prepared by mechanically activating the carbon surface via Ultrasonicating nanoparticles suspension of ground zeolite type 4A.F
... Show MoreThe project has been described the design and construction of a reliable optical testing platform used for evaluate the reflectivity of metal surfaces treated with special paintings required for laser beam attenuation. The platform comprises an Nd-YAG laser system which has been designed and fabricated with specifications to be compatible with their corresponding in laser range finder transmitters used for various applications. The reflectivity of various attenuating paintings, at different detection angles, has been observed. Moreover, the variation of the reflected energy with painting type and metal type to be painted has been studied experimentally. Results illustrated the existence of a definite angle, at which the reflectivity was max
... Show MoreA water resources management for earthen canal/stream is introduced through creating a combination procedure between a field study and the scientific analytical concepts that distinguish the hydraulic problems on this type of stream with using the facilities that are available in HECRAS software; aiming to point the solutions of these problems. Al Mahawil stream is an earthen canal which is subjected to periodic changes in cross sections due to scour, deposition, and incorrect periodic dredging processes due to growth of the Ceratophyllum plants and weeds on the bed and banks of the stream; which affect the characteristics of the flow. This research aims to present a strategy of water resources management through a field study that conducte
... Show MoreTillage appearance device is mechanical, electric-electronic design, getting Patent from the Central Organization for Standardization and Quality Control – Industrial Property Department - Ministry of Planning – The Republic of IRAQ under number Patent 3876 in 20 / 4 / 2014, calculates the number of clods per area by Tillage appearance device, This is done through the generation electrical impulses are sent to the controlled accurate calculates number clods required space and shows the result on the screen in order to see the tillage view per area. Three factor used in these experiment, first factor represents forward speed of tractor three levels (3.5, 4.5, and 5.5 km/h), second factor represent soil moisture content at two levels (14
... Show MoreBacterial toxins are considered to be virulence factors due to the fact that they interfere with the normal processes of the host cell in which they are found. The interplay between the infectious processes of bacteria and the immune system is what causes this impact. In this discussion, we are going to focus on bacterial toxins that act in the extracellular environment, especially on those that impair the activity of macrophages and neutrophils. These toxins are of particular interest since they may be found in a wide variety of bacteria. We will be concentrating our efforts, in particular, on the toxins that are generated by Gram-positive and Gram-negative bacteria. These toxins are able to interact with and have an effect on the many dif
... Show MoreThe performa of evaluation process is a process that should be carried out by all industrial management in order to stand on aspects of development or underdevelopment of the various departments and activities in its industrial project for the purpose of identifying obstacles and find out the causes and then avoid them quickly. And intended to rectify the performance evaluation of the activities of industrial project or economic union by measuring the results achieved within a specific operational process and compare it to what is already targeted, and often the time for comparison of one year.
The process of performance evaluation depends upon several criteria and indicators within the
... Show MoreThe aim of this essay is to use a single-index model in developing and adjusting Fama-MacBeth. Penalized smoothing spline regression technique (SIMPLS) foresaw this adjustment. Two generalized cross-validation techniques, Generalized Cross Validation Grid (GGCV) and Generalized Cross Validation Fast (FGCV), anticipated the regular value of smoothing covered under this technique. Due to the two-steps nature of the Fama-MacBeth model, this estimation generated four estimates: SIMPLS(FGCV) - SIMPLS(FGCV), SIMPLS(FGCV) - SIM PLS(GGCV), SIMPLS(GGCV) - SIMPLS(FGCV), SIM PLS(GGCV) - SIM PLS(GGCV). Three-factor Fama-French model—market risk premium, size factor, value factor, and their implication for excess stock returns and portfolio return
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