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.
When the drawdown pressure amounts to a value below the dew point pressure, a minor droplet of condensate is shaped and accumulated in the close area of wellbore. As the accumulation happens, the saturation of the liquid will grow and a reduction in gas relative permeability will happen, therefore it will affect the productivity. Generally, condensate baking problem in gas wells is being deliberated and studied and numerous techniques have been suggested to solve the problem. The studying of condensate banking dynamics is essential to evaluate the productivity and behavior of the wells of the gas fields.
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This research provides a new method to study praise poetry that can be used as a course to teach English and Arabic to students in the College of Education. This research answers two questions:
- Is it possible to examine praise poetry as a tagmeme?
- Is this analysis of great help in teaching English and Arabic to students in the College of Education?
The data that will be chosen for the purpose of analysis are two of Shakespeare's sonnets and two of AL Mulik's poems. The sonnets selected for this purpose are 17 and 18. AL Mulik's poems selected for the same purpose are 8 and 9.
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... Show MoreThis paper presents a fuzzy logic controller for a two-tank level control system, which is a process with a dead time. The fuzzy controller is a proportional-integral (PI-like) fuzzy controller which is suitable for steady state behavior of the system. Transient behavior of the system was improved without the need for a derivative action by suitable change in the rule base of the controller. Simulation results showed the step response of the two-tank level control system when this controller was used to control this plant and the effect of the dead time on the response of the system.
Futsal and blind football are group games of a competitive nature due to their excitement, excitement, fun, and aesthetic goals with charming artistic touches. This explains the public's passion for these two games, whether healthy people or blind people play them, to expand their vision and knowledge. About these two games, a historical approach is presented about their origins, development, and how they became globally recognized competitive sports with unified rules and world championships at various levels. Studying the origin and global spread of both futsal and blind football and identifying the most prominent developments in the rules and tools for futsal and blind football. The most important findings were that both futsal and footb
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People are supposed to use language harmoniously and compatibly. However, aggression may characterize much of human communication. Aggression has long been recognized as a negative anti-social issue that prevails in most personal interactions. If it abounds in familial communications, it is more dangerous due to its harmful effects on individuals, and consequently on societies. Aggression refers to all the instances in which we try to get our way without any consideration for others. Moriarty’s novel (2014), Big Little Lies, is argued to represent the patterns of aggressive communications. This study aims to find out the motivations behind aggressive language in familial communication in this
... Show MoreA Factorial Study for separation anxiety in students, of Baghdad City
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Due to the importance of nanotechnology because of its features and applications in various fields, it has become the focus of attention of the world and researchers. In this study, the concept of nanotechnology and nanomaterials was identified, the most important methods of preparing them, as well as the preparation techniques and the most important devices used in their characterization.
The research problem is to determine the nature of the historical relationship between the profession of social work and volunteer work. Consequently, the research aims to investigate the nature of this relationship from a socio-historical perspective. Three axes have been used to analyze this relationship: the role of voluntary work in the development of the social work as a profession, the efforts made by social work to reach professionism and to distinguish it from voluntary work, and the relationship between social work and voluntary work. The research is qualitative analytical research and adopts the Mixed Methods Research (MMR). It identifies some literature for the analysis and implementation of a scoping process. It represents a
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There is no adopt in the importance of the optical communications in scientific civil and military applications because of it’s simplicity in manufacturing and it's low cost. The method of optical communication depends upon bearing the light beam the translated informations by a method called the light modulation. This method depends upon changing some light properties as frequency, amplitude and pulse duration according to the translating informations. The changes in the first two properties are concerned optically with the analog modulation while the third one concern at most with digital modulation. All past methods are expensive with low efficiency and needs electrical or magnetic fields. In this technique the source of voice used
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