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 proposed work is an attempt to investigate the stability of the nonlinear system by using a whale optimization algorithm as of one of the meta-heuristic optimization methods, and this investigation was conducted on a single inverted pendulum as a study model. The evaluation measures which were used in this article values of gain and sliding surface of the conventional sliding mode controller to illustrate the extent of the system`s stability. Furthermore, control action, the relationship between error and its derivative, desired, and actual position in addition to sliding response graphically showed the feasibility of the proposed solution. The attained results illustrated considerable improvement in the settling time and minimizing the
... Show MoreThe study aimed to explore the school principals’ servant leadership practices for primary teachers’ perspectives in the Sultanate of Oman, furthermore to investigate the differences in those practices attributable to variables (gender, qualification, educational stage, years of experience, governorate). The study relied on the descriptive approach, by employing the survey research design using the questionnaire as a main tool for data collection, which included five dimensions of servant leadership (altruism, humility, enhancing teacher development, emotional healing, commitment to community development), Data collected from (1094) teachers in basic education schools, and they were chosen randomly. The results of the study indicated
... Show MoreObjectives: To find out the effectiveness of education program application on nurses-midwives' knowledge toward prevention and management of postpartum hemorrhage in delivery room and some socio demographic characteristics Methodology: a quasi -experimental "test-retest"design has carried throughout the present study with the application of a pre –test and post- test for nurses-midwives' knowledge toward postpartum hemorrhage. The study was conducted in six hospitals in Baghdad: Fatima Al – Zahra for Maternity and Pediatric, Al -Elwia maternity, Baghdad Teaching, AL-Imamine Al - Kadhimin Teaching, Al-Karckh maternity and Al-Yarmouk Teaching hospital for the period from 27th May
... Show MoreHaruki Murakami (1949-present) is a contemporary Japanese writer whose works have been translated into fifty languages and won him plenty of Japanese and international awards. His short stories are well constructed in a weird realistic manner and are mixed with elements of surrealism. His novels and short stories fall under the genre of magical realism. One of the major revolving themes that Murakami wrote about was the haunting feeling of emptiness and disconnectedness in a world which seems to care much for materialism and self-interests.
The paper explores two of Murakami’s short stories in his book After the Quake (2000) and the relevance of their themes and characters to Iraq after the q
... Show MoreMany studies and researchers have reported significant evidence that some physical properties of water can be changed as it passes through a magnetic field that can improve water use. This can have a promising potential for applications, especially in the fields of irrigation and drainage. In this research, magnetized water was used to leach salt-affected sandy loam soil. A test rig was designed and constructed to investigate the effects of magnetized water on leaching soil. The rig consists of a magnetization device that can provide variable intensity. Water was supplied from a constant head reservoir to the magnetization device then to the soils that were placed in plastic columns. Five different magnetic intensi
... Show MoreThe aim of this research is to construct an educational program in light of the theory of behavioral cognitive and its impact on the development of the efficient response to students affected by crises (centers of your right to education). To achieve the objectives of the research, two scales were developed by the researcher in addition to two equivalent hypotheses were formulated. The scale contains (26) items divided into five fields; for its validity and reliability were derived based on the measure of efficient response, an educational program based on the theory of behavioral cognition. The test and the educational program were applied to a sample of (60) students from the centers of your right to education, divided into experimenta
... Show MoreModern societies tend to live in an electronic way. Indeed, many citizens and business owners are currently working in an electronic way because the use of information technology systems reduces the number of steps in the routine required to carry out work, and converts manual jobs to automatic, and helps improve the way of serving citizens by providing access to information in a service manner. The e-government can also automate responses to requests for licenses or information, in order to save time and energy for employees in order to provide better services to those reviewers who call directly or attend by themselves to accomplish some exceptional work. Therefore, to raise awareness its services, it is necessary to use various public re
... Show MoreIt is well known that the rate of penetration is a key function for drilling engineers since it is directly related to the final well cost, thus reducing the non-productive time is a target of interest for all oil companies by optimizing the drilling processes or drilling parameters. These drilling parameters include mechanical (RPM, WOB, flow rate, SPP, torque and hook load) and travel transit time. The big challenge prediction is the complex interconnection between the drilling parameters so artificial intelligence techniques have been conducted in this study to predict ROP using operational drilling parameters and formation characteristics. In the current study, three AI techniques have been used which are neural network, fuzzy i
... Show MoreThis study aims to deliver the woman’s image and to unveil on how to be introduced in the TV series. The research is based on the survey method-using content analysis tool. The research sample represented in the TV series produced by the IMN, which were displayed in 2014 and used the pattern of Margaret Gallagher to analyze the content of the series in accordance with the frame analysis theory.
The study came up with declination of the woman’s representation compared with man in Iraqi TV drama, also the study finds that the series introduced the woman according to the personal, social, political, and economic frames in a standardizing method. It focuses on the characteristics always attributed to it as showing her obedient of the
priorities of materials research due to their promising properties, especially in the field of thermoelectricity. The efficiency or performance of thermoelectric devices is expressed in terms of the thermoelectric figure-of-merit (ZT) – a standard indicator of a material’s thermoelectric properties for use in cooling systems. The evaluation of ZT is principally determined by the thermoelectric characteristics of the nanomaterials. In this paper, a set of investigative computations was performed to study the thermoelectric properties of monolayer TMDCs according to the semiclassical treatment of the Boltzmann transport equation. It was confirmed that the thermoelectric properties of 2D materials can be greatly improved compared with thei
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