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.
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A novel welded demountable shear connector for sustainable steel-concrete composite structures is proposed. The proposed connector consists of a grout-filled steel tube bolted to a compatible partially threaded stud, which is welded on a steel section. This connector allows for an easy deconstruction at the end of the service life of a building, promoting the reuse of both the concrete slabs and the steel sections. This paper presents the experimental evaluation of the structural behavior of the proposed connector using a horizontal pushout test arrangement. The effects of various parameters, including the tube thickness, the presence of grout infill, and the concrete slab compressive strength, were assessed. A nonlinear finite element mode
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The Humidification-Dehumidification (HDH) desalination technique offers a viable solution for providing freshwater to populations in water-scarce, remote areas. This study experimentally investigates a novel humidifying method by cross airflow over water-wetted pottery tubes, which function as a humidifier, incorporating a thermoelectric cooler to condense water vapor for freshwater production. To optimize freshwater production and thermal efficiency, meticulous design of these components and appropriate operational parameters are selected. Experiments were performed in three environments with differing temperatures and relative humidity levels, while air velocity varied from 1.02 to 1.89 m/s, and thermoelectric cooler voltage ranged from 6
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Objective: The present study aimed to determine the association of quality of life with the resilience of intensive care unit (ICU) nurses. Methods and Materials: A cross-sectional study was performed, including 105 ICU nurses from five hospitals in Iraq, using a convenience sample method. Data were gathered through a self-administered questionnaire that includes three sections: the demographics, the Brooks Quality of Nursing Work Life survey, and the Connor-Davidson Resilience Scale-10 (CD-RISC-10). Findings: The QWL of the ICU nurses was moderately satisfied (mean = 161.42), and the level of resilience was moderate (mean = 26). A statistically significant positive correlation between QWL and resilience. Conclusion: Strategies
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The 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
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In this paper to isolate and study the properties of the cyclooxygenase-2 (EC: 1.14.99.1) enzyme in the blood of a patient suffering from rheumatoid arthritis and study the effect of natural products of the Soapwort on the activity of purified enzyme. The study involves taking 30 ml of blood from an adult woman 40 years old, who suffers from rheumatoid arthritis disease for 13 years. Serum is separated and subjected to a series of purification processes including: precipitation by ammonium sulfate, filtration by centrifugation radiator, dialysis in presence of ammonium bicarbonate, separation using the technology of ion exchange, lipholization and then estimating approximate molecular weight of the enzyme using gel filtration techni
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This study is concerned with shedding light on the grammatical method of Ibn Hisham Al-Ansari (761 AH), in his explanation of Bant Souad’s poem by the poet Kaab bin Zuhair, and I included a brief description of Ibn Hisham’s life with a number of explanations of this poem, then clarified the most important features of this method The grammar represented by his reliance on hearing and presenting it to analogy with mention of types of analogy, as well as his attribution of opinions to their owners with weighting, selection and balancing, and his attention to reasoning and a number of grammatical ailments, and his approach is also distinguished by following the method of fractal.
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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
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