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.
The study aims to build a model that revolves around the main question of the role of strategic agility (SA) in enhancing organizational excellence (OE). For the purpose of achieving OE and to determine the extent of interest and knowledge of managers at the Midwest Refineries Company (MRC) on the theoretical and practical implications, and on the performance foundations of these two vital variables with the aim of continuous improvement. A questionnaire was used and distributed to a random sample of 54 managers in this important energy production company. The study followed the descriptive analytical approach to answer the questions raised. The study model and dimensions were built according to reference models, most notably the mo
... Show MoreA field Experiment was carried out in Baghdad for the purpose of compare five horticulture machines during used two types of fuel deffirance in octane number, normal and super fuel which produced in Iraqi and measuring the vibrations transmitted of the three axes are longitudinal X , lateral Y and vertical Z from handlebar in (Mowers) to the operator which walks behind the mower, and the determine of the productivity practical of cutting, productivity passing and fuel consumption. Experiment Factorial used with two factors, The first factor was Five Mowers vary in width , types, weight and company manufacturer, The Second factor was the types of fuel used internal combination engine horticulture mowers were Normal fuel with Octane Number 82
... Show MoreA novel demountable shear connector is proposed to link a concrete slab to steel sections in a way that resulting steel-concrete composite floor is demountable, i.e. it can be easily dismantled at the end of its service life. The proposed connectors consist of two parts: the first part is a hollow steel tube with internal threads at its lower end. The second part is a compatible partially threaded bolted stud. After linking the stud to the steel section, the hollow steel tube can be fastened over the threaded stud, which create a complete demountable shear connector. The connector is suitable for use in both composite bridges and buildings, and using cast in-situ slabs, precast solid slabs, or hollow-core precast slabs. A series of push-off
... Show MoreIn this work, the effect of partial amounts of gases in gas mixture of a CW CO2 laser on the output power was investigated. Also their effect on the condition determining the glow-discharge self-sustaining required for pumping the active medium was studied. Two fit relations were derived to predict the output laser power and the electric field to unit pressure ratio as functions to the partial amounts of gases. Results presented in this work could be used fruitfully to determine some of the optimum operational conditions of glow-discharge low-power CW CO2 lasers.
Show the greatness of Allah Almighty when contemplating the benefits of trees and plants in
Life in general and trees mentioned in the Koran in particular, do not have to meditate that
He acknowledges the greatness of the Almighty Creator, and his preference over man, that he is prepared for his livelihood
And give him what he can do in this life to the fullest.
The study also stressed the need to urge people to this great blessing trees
By preserving them and wasteful wastefulness.
The study also pointed to the need to guide people towards the aesthetics and improvements of
Look through and enjoy the beauty of trees, flowers, greenery and fruits ..
Software Defined Network (SDN) is a new technology that separate the control plane from the data plane. SDN provides a choice in automation and programmability faster than traditional network. It supports the Quality of Service (QoS) for video surveillance application. One of most significant issues in video surveillance is how to find the best path for routing the packets between the source (IP cameras) and destination (monitoring center). The video surveillance system requires fast transmission and reliable delivery and high QoS. To improve the QoS and to achieve the optimal path, the SDN architecture is used in this paper. In addition, different routing algorithms are used with different steps. First, we eva
... Show MoreAn environmentally begnin second derivative spectrometric approach was developed for the estimation of the dissociation constants pKa(s) of metformin, a common anti-diabetic drug. The ultraviolet spectra of the aqueous solution of metformin were measured at different acidities, then the second derivative of each spectrum was graphed. The overlaid second derivative graphs exhibited two isobestic points at 225.5 nm and 244 nm pointing out to the presence of two dissociation constants for metformin pKa1 and pKa2, respectively. The method was validated by evaluating the reproducibility of the acquired results by comparing the estimated values of the dissociation constants of two different strategies that show excellent matching. As we
... Show MoreAs one type of heating furnaces, the electric heating furnace (EHF) typically suffers from time delay, non-linearity, time-varying parameters, system uncertainties, and harsh en-vironment of the furnace, which significantly deteriorate the temperature control process of the EHF system. In order to achieve accurate and robust temperature tracking performance, an integration of robust state feedback control (RSFC) and a novel sliding mode-based disturbance observer (SMDO) is proposed in this paper, where modeling errors and external disturbances are lumped as a lumped disturbance. To describe the characteristics of the EHF, by using convection laws, an integrated dynamic model is established and identified as an uncertain nonlinear second ord
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