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 purpose of this research is to identify the youth issues in Talk Shows in the Iraqi satellite channels via monitoring a sample of episodes of the Talk Shows episodes which are concerned and analyzed the youth issues in the Iraqi satellite channels, namely, «Hala Shabab Program» at Al-Iraqia satellite Channel and «Shabab wa Banat Program» at Al-Sumaria satellite Channel by recording and re-watching them again. This research is classified as one of descriptive researches. The survey method was adopted in this study.
For this purpose, the researcher prepared an analysis form. The researcher de
... Show MoreDynamic machine foundations can be considered as a necessary component of the industrial infrastructure. Design of the dynamic equipment foundations has, however, traditionally been grounded on a rule of thumb that is inaccurate and rigid to use at the discretion of the engineers. The conventional rule of thumb, which includes minimum weight ratios and resonance avoidance criteria, has been used singularly with two poles, which can be either conservatively designed systems that are too heavy, or systems that are going to experience too much vibration and fatigue. This paper presents a novel, analytical framework for the reinterpretation of traditional design practices, using a physics-based approach, and results in a single, unified overall
... Show MoreThe study intends to explore the obstacles that encounter a program of rehabilitating released prisoners as perceived by prisoners themselves in tubas' province. To this end, the researcher used a questionnaire as an instrument which was applied on (150) prisoner had chosen randomly to collect the study data. The findings revealed no significant differences among obstacles the encounter program regarding to the following variables: age, detention period, and number of detention, additionally, the findings found that there is a variance of obstacles mean according to the prisoners themselves, rehabilitation program, and the facility of that program.
هدف البحث إلى بناء مقياسين تخصصين للنزاعات اللاشعورية وحرية الإرادة لمدربي بعض ألعاب القوى والتعرف على مستوى كل منهما لديهم، وإعداد برنامج إرشادي نفسي مستند لرفع مستوى الحالات اللاشعورية وحرية الإرادة للمدربين الذين يعانون من انخفاض مستوى النزاعات اللاشعورية وحرية الإرادة، والتعرف على تأثير البرنامج الإرشادي نفسي في النزاعات اللاشعورية وحرية الإرادة لدى مدربي بعض ألعاب القوى، لتفترض بذلك الباحثة بإ
... Show MoreSeptember 11th attacks held the biggest tragedy in American history. It was a day of grief, and it proved that America was not immune to attacks and threat. Afterwards life has changed not only for the American Muslims but also American Christians and Jews and to people from other religions. The cruelty of that day has left its shed particularly on the Muslims’ life in America who in reality had nothing to do with the attacks. Arab American Muslim writer Laila Halaby’s novel, Once in a Promised Land, intensely displays the problems that Arab Muslims went through after September 11th attacks. This paper discusses this issue through analysing Halaby’s novel, where she deals with the issues such as discrimination, stereotype, and prejudi
... Show MoreLet f and g be a self – maps of a rational exterior space . A natural number m is called a minimal coincidence period of maps f and g if f^m and g^m have a coincidence point which is not coincidence by any earlier iterates. This paper presents a complete description of the set of algebraic coincidence periods for self - maps of a rational exterior space which has rank 2 .
In addition to being a novel medication in treating obesity and type 2 diabetes mellitus, tirzepatide is currently being studied to assess its effectiveness and safety on various health parameters, specifically with an emphasis on the neurological field, including sleep medicine and neurodegenerative conditions. In this perspective, we highlight the recent FDA approval of tirzepatide’s use for the treatment of obstructive sleep apnea, with recommendations for future research to extend use in children and adolescents.
Fluidization process is widely used by a great assortment of industries worldwide and represents a trillion dollar industry [6]. They are currently used in separation, classification, drying and mixing of particles, chemical reactions and regeneration processes; one of these processes is the mass transfer from an immersed surface to a gas fluidized bed
A total of (25) stool samples were collected from children and adults (2- 4) years old suffering from diarrhea to isolate E. coli strains that produce heat-stable enterotoxin a (STa), and after performing microscopic examination, cultural characterization and biochemical identification only (11) isolates showed positive E. coli. STa activity was estimated by using suckling mouse assay (SMA) and from these (11) isolates only (5) showed STa activity and the one with the highest STa activity was selected for large scale production of STa, which was followed by partial purification using ion-exchange chromatography (normal phase) using DEAE sephadex A-50 column. After purification and determination of protein concentration by using the standard
... Show More