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.
There many methods for estimation of permeability. In this Paper, permeability has been estimated by two methods. The conventional and modified methods are used to calculate flow zone indicator (FZI). The hydraulic flow unit (HU) was identified by FZI technique. This technique is effective in predicting the permeability in un-cored intervals/wells. HU is related with FZI and rock quality index (RQI). All available cores from 7 wells (Su -4, Su -5, Su -7, Su -8, Su -9, Su -12, and Su -14) were used to be database for HU classification. The plot of probability cumulative of FZI is used. The plot of core-derived probability FZI for both modified and conventional method which indicates 4 Hu (A, B, C and D) for Nahr Umr forma
... Show MoreANN modeling is used here to predict missing monthly precipitation data in one station of the eight weather stations network in Sulaimani Governorate. Eight models were developed, one for each station as for prediction. The accuracy of prediction obtain is excellent with correlation coefficients between the predicted and the measured values of monthly precipitation ranged from (90% to 97.2%). The eight ANN models are found after many trials for each station and those with the highest correlation coefficient were selected. All the ANN models are found to have a hyperbolic tangent and identity activation functions for the hidden and output layers respectively, with learning rate of (0.4) and momentum term of (0.9), but with different data
... Show MoreThe biggest problem of structural materials for fusion reactor is the damage caused by the fusion product neutrons to the structural material. If this problem is overcomed, an important milestone will be left behind in fusion energy. One of the important problems of the structural material is that nuclei forming the structural material interacting with fusion neutrons are transmuted to stable or radioactive nuclei via (n, x) (x; alpha, proton, gamma etc.) reactions. In particular, the concentration of helium gas in the structural material increases through deuteron- tritium (D-T) and (n, α) reactions, and this increase significantly changes the microstructure and the properties of the structural materials. T
... Show MoreThe flow in a manifolds considered as an advanced problem in hydraulic engineering applications. The objectives of this study are to determine; the uniformity qn/q1 (ratio of the discharge at last outlet, qn to the discharge at first outlet, q1) and total head losses of the flow along straight and rectangular loop manifolds with different flow conditions. The straight pipes were with 18 m and 19 m long and with of 25.4 mm (1.0 in) in diameter each. While, the rectangular close loop configuration was with length of 19 m and with diameter of 25.4 mm (1.0 in) also. Constant head in the supply tank was used and the head is 2.10 m. It is found that outlets spacing and manifold configuration are the main factors aff
... Show Morethe researchers Sought to determine the impact of the customer contact (Within a client contact there are two times, first is the total time required to create a service and within it there is contact time while the second time is the time of client contact ؛ where means a time that records the physical presence of the customer during the process of service) on operations performance by concentrate attention on the cost (labor productivity) and quality (patient ratio to the doctor) and speed (cycle time) and flexibility (the flexibility range) , as well as ruling out variable of innovation because of impossibility to measure this variable in the Specialty Center for Dental in al-alwia due to the center is lacking of mechanisms t
... Show MoreThis study has been undertaken to investigate the mineralogical properties and morphological features of sand fraction in some soils of Baghdad / Iraq.The morphological features of sand fractions were studied by Polarized optical microscope. Results have shown that the grains of these minerals from samples of sands have different colors, those from the surface horizons have dark brownish spots, due to staining by organic matter, and have a yellowish– to yellowish brown spots due to accumulation of Iron oxides.Results of light minerals indicated that quartz is dominant due to effect of parent material of these soils. Two types of opaque minerals (black and brown) are found, whereas t
This research aims to test the effect of strategic cohesion with its dimensions (organizational excitement, organizational casting, organizational synergy) as an independent variable on administrative excellence as a dependent variable in the Ministry of Planning, and through surveying several employees (general managers, heads of departments, and units managers). As a research community, and based on the importance of the research topic in the aforementioned research community. The researchers have adopted the descriptive-analytical using the questionnaire as the main data collection. 155 questionnaires were distributed, yet,114 of them were retrieved and 110 were used for final statistical analysis. The researchers used the relev
... Show MoreThe Diwan of Imam Al-Shafi’i acquires great importance, as Al-Shafi’i is an authority in the language, and when I saw that no one had preceded me in exploring its depths, I took my tool and turned my face towards it intending to study the triple verb in it. I stop at these verbs and the student pauses for their morphological forms, looking at the significance of the triple verb more with one letter, two letters, and three letters, and I found that they are many, and such research cannot contain them all, so the choice came to choose the triple verb more with one letter, and the significance of the increase in it, as the increase in The building necessitates an increase in the meaning, and from here the study was limited to the triple
... Show MoreTransparent nano- coating was prepared by Sol-Gel method from titanium dioxide TiO2 which has the ability to self-cleaning coating used for hospitals, laboratories, and places requiring permanent sterilization. Three primary colors are selected (red, blue, and yellow) as preliminary study to the effect of these colors on the nano-coating. Three traditional oil paints color were used as base, then coated by a layer of TiO2-Sol and deposited on the paints. The optical properties of TiO2-Sol were measured; the maximum absorption wavelength at (λmax=387 nm), the refractive index (n=1.4423) and the energy band gap (Eg=3.2 eV). The structure properties found by X-ray diffraction of TiO
The Dagum Regression Model, introduced to address limitations in traditional econometric models, provides enhanced flexibility for analyzing data characterized by heavy tails and asymmetry, which is common in income and wealth distributions. This paper develops and applies the Dagum model, demonstrating its advantages over other distributions such as the Log-Normal and Gamma distributions. The model's parameters are estimated using Maximum Likelihood Estimation (MLE) and the Method of Moments (MoM). A simulation study evaluates both methods' performance across various sample sizes, showing that MoM tends to offer more robust and precise estimates, particularly in small samples. These findings provide valuable insights into the ana
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