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.
Accurate predictive tools for VLE calculation are always needed. A new method is introduced for VLE calculation which is very simple to apply with very good results compared with previously used methods. It does not need any physical property except each binary system need tow constants only. Also, this method can be applied to calculate VLE data for any binary system at any polarity or from any group family. But the system binary should not confirm an azeotrope. This new method is expanding in application to cover a range of temperature. This expansion does not need anything except the application of the new proposed form with the system of two constants. This method with its development is applied to 56 binary mixtures with 1120 equili
... Show MoreThis research aims to identify the role of external environment factors on the quality of educational services, from the academic point of view, where the distribution of a questionnaire to a random sample of (100) university professors, and then analyzing a model, and test the validity of this model using structural modeling (SEM) (Structural Equation Modeling).
And then test the relationships between variables using the software of Statistical Package for Social Sciences (SPSS V.18), the research found a number of conclusions, the most important conclusion is: the external environment factors has significant impact on the quality of educational services.
The study of the relationship between the coordinates of the sun and the moon with the crescent visibility factors has not been previously treated in a detailed and accurate way in research and previous studies, despite its religious importance. Accordingly, this paper aims to study the relationship between the crescent visibility factors (age, lag time, elongation (ARCL), arc of vision or relative altitude (ARCV), relative azimuth (DAZ), and crescent width (W), with coordinates of the sun and the moon), and how it varies during the day of the crescent's observation. In this paper, Matlab programs were designed to calculate the ecliptic sun and moon coordinates (λ, β) and in the presence of all perturbation impacts (planets), th
... Show MoreThe aim of this research was to analyze the financial reporting requirements of segmental information that stipulated by the Iraqi accounting rules, investigating the extent of it compliance with the requirements of the International Financial Reporting Standard No.8 (IFRS 8) and the Statement of Financial Standards No.131 (SFAS 131). Also the research aimed to identify the segmental disclosure practices in listed corporations on Iraq Stock Exchange (ISX), basing on a hypotheses said that “the insufficient of Iraqi financial reporting requirements of segmental information affect<
... Show MoreThis research (The families of martyrs, victims of terrorism, war operations and military mistakes opinion about Al- Shuhada`a Establishment ) came to know and diagnose the mental image the martyrs victims of terrorism carries about the performance of Al- Shuhada`a Establishment and the services it provides to them, and to monitor the contents of that image that they had regarding their privileges and rights that Al- Shuhada`a Establishment supposed to give it to them, according to their law. The research problem was represented by the main question: (What is the image of Al- Shuhada`a Establishment among the families of martyrs, victims of terrorism, war operations and military mistakes), and this research was classified within the d
... Show MoreThe aim of this article is to solve the Volterra-Fredholm integro-differential equations of fractional order numerically by using the shifted Jacobi polynomial collocation method. The Jacobi polynomial and collocation method properties are presented. This technique is used to convert the problem into the solution of linear algebraic equations. The fractional derivatives are considered in the Caputo sense. Numerical examples are given to show the accuracy and reliability of the proposed technique.
The Costing Accounting is one the analytic tools which plays important role by support the management in planning& control and decisions-making ,as it became attendant necessity to establish any project whether industrial ,commercial ,service or agriculture ..etc.
The consolidated accounting system has committed the companies to have their active costing system in which the management can obtain their own data, but we found most of the economic units face problems of applying the costing system because of reasons related to the system design itself or might be related to the requirements of the application success.
... Show MoreTwo Schiff bases, namely, 3-(benzylidene amino) -2-thioxo-6-methyl 2,5-dihydropyrimidine-4(3H)-one (LS])and 3-(benzylidene amino)-6-methyl pyrimidine 4(3H, 5H)-dione(LA)as chelating ligands), were used to prepare some complexes of Cr(III), La(III), and Ce(III)] ions. Standard physico-chemical procedures including metal analysis M%, element microanalysis (C.H.N.S) , magnetic susceptibility, conductometric measurements, FT-IR and UV-visible Spectra were used to identify Metal (III) complexes and Schiff bases (LS) and (LA). According to findings, a [Cr(III) complex] showed six coordinated octahedral geometry, while [La(III), and Ce(III) complexes]were structured with coordination number seven. Schiff's bases a
... Show MoreMaxim Gorky’s Mother is one of the most important literary genre in social realism, in which he depicts female characters with revolutionary fervor and enthusiasm, projecting his social ideologies and dreams. Though the novel unique importance lies in the fact that it has been thoroughly analyzed by many writers, historians and sociologists, there are almost no studies devoted to the role of women out of a Marxist and feminist point of view. The present paper sheds light on the Russian woman‘s important role in overcoming all adversity and gain her position on Social Realism.
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... Show MoreAnalyzing plantar pressure trajectories is crucial for assessing foot behavior in dynamic gait stability. We propose the identification of foot symmetry and the detection of deformities by analyzing the trajectories of the center of pressure (CoP) and peak pressure (PP). First, using a foot pressure mapping system, plantar pressure data are acquired during a normal gait cycle. After the data have been acquired, post processing extracts both the CoP and PP trajectories over the spatiotemporal domain of foot motion for each foot independently. For this purpose, we used the optical flow technique which accurately estimates the direction of foot motion. The extracted trajectories of each foot are then segmented into, the medial and lateral regi
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