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.
Interested in this research shed light on the reality of foreign trade to Iraq Who suffers from a marked deterioration due to poor economic diversification of the country And increase the degree of economic exposure , Which creates a state of extreme caution towards the question of accession to the (WTO) , As controls Iraq's foreign trade commodity , a president of one oil As well as the contribution of this item , and by a large formation in GDP , And that such a large and dangerous decline in the degree of economic diversification will create negative effects On overall economic activity components&
... Show MoreWith the recent growth of global populations, main roads in cities have witnessed an evident increase in the number of vehicles. This has led to unprecedented challenges for authorities in managing the traffic of ambulance vehicles to provide medical services in emergency cases. Despite the high technologies associated with medical tracks and advanced traffic management systems, there is still a current delay in ambulances’ attendance in times of emergency to provide patients with vital aid. Therefore, it is indispensable to introduce a new emergency service system that enables the ambulance to reach the patient in the least congested and shortest paths. However, designing an effici
The study aimed to reveal the level of knowledge and tendencies of high- study students specializing in curriculum and teaching methods at King Khalid University towards harmonious strategies with brain-based learning (BBL). And Then, putting a proposed concept to develop knowledge and tendencies of high-study students specializing in curriculum and teaching methods at King Khalid University towards harmonious strategies with Brain-based learning (BBL). For achieving this goal, a cognitive test and a scale of tendency were prepared to apply harmonious strategies with brain-based learning. The descriptive approach was used because it suits the goals of the study. The study sample consisted of (70) male and female students of postgraduate
... Show MoreIt is necessary to use the means of recovery and other means that help to get rid of the effects of fatigue, as the game of badminton and the effectiveness of running 800 meters fall within the mixed system with the superiority of the anaerobic system by more than the air system, so requires the development of energy systems In proportion to the time of the match for badminton players and their travels and high performance and ability to tolerate the high level of lactic acid in the muscles and blood and increase the pain associated with the fatigue that occurs during the performance. In light of the physical and physiological processes of these actions N it should seek through training programs to develop your endurance and wind energy sys
... Show MoreThe m-consecutive-k-out-of-n: F linear and circular system consists of n sequentially connected components; the components are ordered on a line or a circle; it fails if there are at least m non-overlapping runs of consecutive-k failed components. This paper proposes the reliability and failure probability functions for both linearly and circularly m-consecutive-k-out-of-n: F systems. More precisely, the failure states of the system components are separated into two collections (the working and the failure collections); where each one is defined as a collection of finite mutual disjoint classes of the system states. Illustrative example is provided.
In this article four samples of HgBa2Ca2Cu2.4Ag0.6O8+δ were prepared and irradiated with different doses of gamma radiation 6, 8 and 10 Mrad. The effects of gamma irradiation on structure of HgBa2Ca2Cu2.4Ag0.6O8+δ samples were characterized using X-ray diffraction. It was concluded that there effect on structure by gamma irradiation. Scherrer, crystallization, and Williamson equations were applied based on the X-ray diffraction diagram and for all gamma doses, to calculate crystal size, strain, and degree of crystallinity. I
... Show MoreThe new sustainable development goals set by the UN include a goal of making cities inclusive, safe, sustainable, and resilient. Cities are growing at huge rates, and conditions of deteriorating QOL̛s are increasing in the form of poor access to services, and slums are remarkable, especially in the cities of the Middle East; hence, the research problem can arise from a lack of knowledge regarding the in determination of a way to assess the resilience of cities to develop mechanisms that will improve the quality of urban life. In this study, a tool called CRF has been applied for the assessment of the city's resilience principles of health and quality of life, economics and social, infrastructure and environmental systems, and the principle
... Show MoreObjective(s): This research aims at evaluating the quality of pulmonary tuberculosis patients life before and after applying the suggested instructional program, and to find out relationships among distribution of an overall assessment quality of life improvement and socio-demographic characteristics variables. Methodology: Self controlled design studying effectiveness of applying instructional program on quality of life for pulmonary tuberculosis patients among sample size (65) patients from primary health care centers/AL-Sadur City sector-the consultation clinic of chest and respiratory diseases at AL
This research presents a new algorithm for classification the
shadow and water bodies for high-resolution satellite images (4-
meter) of Baghdad city, have been modulated the equations of the
color space components C1-C2-C3. Have been using the color space
component C3 (blue) for discriminating the shadow, and has been
used C1 (red) to detect the water bodies (river). The new technique
was successfully tested on many images of the Google earth and
Ikonos. Experimental results show that this algorithm effective to
detect all the types of the shadows with color, and also detects the
water bodies in another color. The benefit of this new technique to
discriminate between the shadows and water in fast Matlab pro
The research aims to determine the required rate of return according to the Fama and French five-factor model, after strengthening it by adding the indebtedness factor to build the Fama and French six-factor model FF6M-DLE. The effect of the indebtedness factor on the company's profitability and the real value of the ordinary shares calculated according to the (equivalent ascertainment) model and its suitability with the company's situation, and an analysis of the fluctuation between the market value and the real value of the ordinary stocks.