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.
At a time when the general rules in the different legal systems require the presence of two parties to the contract, one of which is issued the first expression of the will and is called the offer, and the other is issued from the other and is called the acceptance. A special type of contracts emerged in the beginning of the last century called the “unilateral contracts”. The side sparked a major jurisprudential dispute, as well as the issuance of several contradictory judicial rulings on it. Hence, this research came to highlight this special type of contract. Key words: the definition of a unilateral contract, its distinction from other legal situations, and its effects.
An electrocoagulation process has been used to eliminate the chemical oxygen demand (COD) from wastewaters discharged from the Al-Muthanna petroleum refinery plant. In this process, a circular aluminum bar was used as a sacrificial anode, and hallow cylinder made from stainless steel was used as a cathode in a tubular batch electrochemical Reactor. Impacts of the operating factors like current density (5-25mAcm-2), NaCl addition at concentrations (0-2g/l), and pH at values (3-11) on the COD removal efficiency were studied.
Results revealed that the increase in current density increases the COD removal efficiency, whereas an increase
Double drum dryer is operated for producing pregelatinized maize starches using feed starch slurries of different
solids(7, 10 and13 g/100 g )content . Steam pressure (2,3,and 4 bar), the level of pool between the drums (4,7,and 10
cm) , and speed of drums rotation (3,4,and 6 rpm) are varied together with the feed solids content in a practical range of
values. The response of the dryer is registered by measuring several output variables, i.e. external drum temperature,
product moisture content, mass flow rate.
In this work Laser wireless video communication system using intensity modualtion direct
detection IM/DD over a 1 km range between transmitter and receiver is experimentally investigated and
demonstrated. Beam expander and beam collimeter were implemented to collimete laser beam at the
transmitter and focus this beam at the receiver respectively. The results show that IM/DD communication
sysatem using laser diode is quite attractive for transmitting video signal. In this work signal to noise
ratio (S/N) higher than 20 dB is achieved in this work.
The lower Cretaceous sandstones of Zubair and Nahr Umr formations are the main producing reservoirs in Subba oilfield in southern Iraq. Key differences in their petrophysical and depositional attributes exist affecting their reservoir characteristics. The evaluation of well logs and core porosity-permeability data show better reservoir properties in Nahr Formation. The Litho-saturation logs indicate greater thickness of oil-saturated reservoir units for Nahr Unr Formation associated with lower values of shale volume, and higher values of effective porosity. In addition, higher values of permeability for Nahr Umr Formation is suggested by applying porosity-irreducible water saturation cross plot. The reducing reservoir quality of Zub
... Show MoreThe national pharmaceutical industry is pivotal for both the health sector and the national economy. This study aims to identify determinants of national drug products acceptance. The objectives of this study were to quantitatively measure the level of patient and community pharmacist acceptance of national drug products available in community pharmacies and to qualitatively explore the barriers facing national pharmaceutical companies and investigate the suggested solutions.
This cross-sectional study used an explanatory mixed method design. It was conducted in Baghdad, Iraq from July through October 2018. The stud
Emotional blackmail is generally defined as manipulating others' emotions for personal gain. It is a type of manipulation that damages healthy relationships among people and turns them into toxic relations leaving the victim in a state of depression and under stress of losing something s/he holds dear. This study aims to identify the pragmatic techniques of emotional blackmail used by both blackmailers and victims in "No One Would Tell" (2018). To do so, the researchers developed an eclectic model comprising Forward and Frazier's (1997) emotional blackmail, Searle’s speech acts (1979), Brown and Levinson’s politeness strategies (1987), Culpeper’s impoliteness strategies (1996, 2005), and Mayfield's taxonomy of fallacy (2007)
... Show MoreThe report includes a group of symbols that are employed within a framework that gives a language of greater impact. This research discusses the problem of the semiotic employment of religious symbols in press reports published in the electronic press across two levels: Reading to perceive the visual message in its abstract form, and the second for re-understanding and interpretation, as this level gives semantics to reveal the implicit level of media messages through a set of semiotic criteria on which it was based to cut texts to reach the process of understanding and interpretation.
The report includes a group of symbols that are employed within a framework that gives a language of greater impact. This research discusses the p
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