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.
<span lang="EN-US">The fundamental of a downlink massive multiple-input multiple-output (MIMO) energy- issue efficiency strategy is known as minimum mean squared error (MMSE) implementation degrades the performance of a downlink massive MIMO energy-efficiency scheme, so some improvements are adding for this precoding scheme to improve its workthat is called our proposal solution as a proposed improved MMSE precoder (PIMP). The energy efficiency (EE) study has also taken into mind drastically lowering radiated power while maintaining high throughput and minimizing interference issues. We further find the tradeoff between spectral efficiency (SE) and EE although they coincide at the beginning but later their interests become con
... Show MoreAlbizia lebbeck biomass was used as an adsorbent material in the present study to remove methyl red dye from an aqueous solution. A central composite rotatable design model was used to predict the dye removal efficiency. The optimization was accomplished under a temperature and mixing control system (37?C) with different particle size of 300 and 600 ?m. Highest adsorption efficiencies were obtained at lower dye concentrations and lower weight of adsorbent. The adsorption time, more than 48 h, was found to have a negative effect on the removal efficiency due to secondary metabolites compounds. However, the adsorption time was found to have a positive effect at high dye concentrations and high adsorbent weight. The colour removal effi
... Show MorePurpose: the purpose of study is estimate the Risk premium, Interest rate, Inflation and FDI in the through of Coronavirus in the MENA countries. Theoretical framework: The theoretical framework included the study of the main variables, which are risk premium, interest rate, inflation, and foreign direct investment during the Corona virus pandemic. Design/methodology/approach: Concentrating on “COVID-19”, as an effective factor on the Foreign direct investment (FDI), I employ data of “MENA (Middle East and Northern Africa)” countries from 2000 to 2021 to investigate the impact of COVID-19, financial and macroeconomic indicators on FDI relying on the analytic research approach of Static panel data regression, includ
... Show MoreMicrobial Desalination Cell (MDC) is capable of desalinating seawater, producing electrical power and treating wastewater. Previously, chemical cathodes were used, which were application restrictions due to operational expenses are quite high, low levels of long-term viability and high toxicity. A pure oxygen cathode was using, external resistance 50 and 150 k Ω were studied with two concentrations of NaCl in the desalination chamber 15-25 g/L which represents the concentration of brackish water and sea water. The highest energy productivity was obtained, which amounted to 44 and 46 mW/m3, and the maximum limit for desalination of saline water was (31% and 26%) for each of 25 g / L and 15 g / L, respectively, when using an ex
... Show MoreThe unexpected death of humans due to a lack of medical care is a serious problem. Additionally, the number of elderly people requiring continuous care is increasing. A global aging population poses a challenge to the sustainability of conventional healthcare systems for the future. Simultaneously, recent years have seen remarkable progress in the Internet of Things (IoT) and communication technologies, alongside the growing importance of artificial intelligence (AI) explainability and information fusion. Therefore, developing smart healthcare systems based on IoT and advanced technologies is crucial. This would open up new possibilities for efficient and intelligent medical system
The research aims to test the effect of the behavioral factors (intangible) represented by an explanatory variable represented by organizational silence and a responsive variable of quality of Function life. The problem was the negative effects of the organizational silence on the morale of the employees and consequently their performance and the quality of function life. To collect the data and information needed to measure the two variables of research conducted in the health center / Sulaikh by taking a sample of (40) employees to test the hypotheses of research through the survey of their views, using statistical tools non parametric using the program. The most important recommendations were the establishment of training workshops fo
... Show MoreThis study aims to explore the impact of the interaction of the university leadership and the university organizational environment on the performance level of the staff at Al-Maaqal university. This university was chosen as a field of study because it is a new university and needs studies that develops and contributes to improve its overall performance. The problem defined by the following question: to what extent does the interaction of the university leadership and the university organizational environment affect the performance level of the teaching staff at AlMaaqal University?). The method of this study adopted a major hypothesis in which there is a statistically significant effect of university leadership and university environment o
... Show MoreThe study aims to indicate the role of the mechanisms and principles of corporate governance in the activation of social responsibility reports, and increase disclosure, to achieve sustainability, legitimacy, and integrity of the business. Through the presentation of the conceptual framework for corporate governance and social responsibility, identify the key dimensions of social responsibility and the statement of the relationship between the mechanisms of governance and social responsibility reports in accordance with these dimensions. To prove the hypothesis research has selected a sample of listed companies in the Iraqi market for securities,
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