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.
Malaysia has been supported by one of the high-speed fiber internet connections called TM UniFi. TM UniFi is very familiar to be used as a medium to apply Small Office Home Office (SOHO) concept due to the COVID-19 pandemic. Most of the communication vendors offer varieties of network services to fulfill customers' needs and satisfaction during the pandemic. Quality of Services is queried by most users by the fact of increased on users from time to time. Therefore, it is crucial to know the network performance contrary to the number of devices connected to the TM UniFi network. The main objective of this research is to analyze TM UniFi performance with the impact of multiple device connections or users' services. The study was conducted
... Show MoreThe present paper discusses morphological and syntactic structures of time in Russian language. The morphological and syntactic structures are considered part component of time category in Russian language.
The morphological categories of time are formed through a various types of expressions .Tenses generally express time relative to the moment of speaking. In some contexts, however, their meaning may be relativized to a point in the past ,present or future which is established in the discourse .Some languages have different verb forms or constructions and that are opposed in meaning not in syntactic category. Hence, the present study traces and compares the syntacti
... Show MoreBackground: DVT is a very common problem with a very serious complications like pulmonary embolism (PE) which carries a high mortality,and many other chronic and annoying complications ( like chronic DVT, post-phlebitic syndrome, and chronic venous insufficiency) ,and it has many risk factors that affect its course, severity ,and response to treatment. Objectives: Most of those risk factors are modifiable, and a better understanding of the relationships between them can be beneficial for better assessment for liable pfatients , prevention of disease, and the effectiveness of our treatment modalities. Male to female ratio was nearly equal , so we didn’t discuss the gender among other risk factors. Type of the study:A cross- secti
Diyala river is the most important tributaries in Iraq, this river suffering from pollution, therefore, this research aimed to predict organic pollutants that represented by biological oxygen demand BOD, and inorganic pollutants that represented by total dissolved solids TDS for Diyala river in Iraq, the data used in this research were collected for the period from 2011-2016 for the last station in the river known as D17, before the river meeting Tigris river in Baghdad city. Analysis Neural Network ANN was used in order to find the mathematical models, the parameters used to predict BOD were seven parameters EC, Alk, Cl, K, TH, NO3, DO, after removing the less importance parameters. While the parameters that used to predict TDS were fourte
... Show MoreChapter-1
Problem of the research:
The studies and researches have noticed the aggravation of violence practice in all educational means using different and innovated styles against children in the school and house in order to upbringing by the parents or the school .
It is a training method for the person to participate in the society and prepare him to be an effective member.
The current research confines the children in age (6-12) years old representing the primary stage who face different kind of violence during the familiar or school education.
The current research aims to:
1 – The kinds of violence which happens to the children in the primary
... Show MoreThe present study has three objectives: 1) to investigate the prevalence of complex nominals in economic discourse represented via the selected business news texts, 2) to shed some light on the most common translation errors made by second year students in the Department of Translation in rendering complex nominals into Arabic, and 3) to detect the possible causes behind such translation errors and suggest some translation tips which might sound helpful to the students of translation to find the most suitable translation equivalent. The present study is based on an empirical survey in which a selective analysis of someeconomic texts represented in business news texts is made. A corpus of 159 complex nominals was selected from seven busin
... Show MoreThis study aims to identify the level of application of blue ocean leadership activities in public organizations and to build a conceptual and cognitive framework around this concept. The study adopted a descriptive-analytical approach, and the research sample consisted of (95) individuals from the senior management working at the center of the Iraqi Ministry of Communications (director general, department manager, section head). The data analysis technique used is structural equation modeling (SEM) and the Statistical Package for the Social Sciences (SPSS). The results indicate that the senior management in the Ministry of Communications is working to adopt the blue ocean leadership style through its activities, but not to the leve
... Show MoreDifferent frequency distributions models were fitted to the monthly data of raw water Turbidity at water treatment plants (WTPs) along Tigris River in Baghdad. Eight water treatment plants in Baghdad were selected, with raw water turbidity data for the period (2008-2014). The frequency distribution models used in this study are the Normal, Log-normal, Weibull, Exponential and two parameters Gamma type. The Kolmogorov-Smirnov test was used to evaluate the goodness of fit. The data for years (2008-2011) were used for building the models. The best fitted distributions were Log-Normal (LN) for Al-Karkh, Al-Wathbah, Al-Qadisiya, Al- Dawrah and, Al-Rashid WTPs. Gamma distribution fitted well for East Tigris and Al-Karamah WTPs. As for Al-
... Show Moreالحمد الله أولا واخرا وبعد .. إن الواقع الذي عايشه الناس في ظل دولة المسلمين منذ إقامة دولة الإسلام بعد بعثة الرسول الكريم (صلى الله عليه وسلم ) في المدينة ولأكثر من أربعة عشر قرنا نرى إنه عاش في كنف هذه الدولة الكبيرة من بلاد الصين شرقا وإلى وسط أوربا وجنوب فرنسا غربا العشرات من الملل و الأديان والأجناس وممن لا يدينون بالإسلام وهم كما تحفظ لهم دولة الإسلام منهم وعيشهم الرغيد فهم يمارسون شعائرهم وطقوسهم الديني
... Show More