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.
The research is a vision of the future of industry in Iraq, so it is may be outside the ceiling of the capabilities of the Iraqi economy, and therefore it is exaggerated. Therefore, future plans must be applicable through the availability of capabilities. Everyone knows that the financial and administrative corruption and mismanagement of resources are the main cause of the inefficiency of the industrial sector, and the failure to exercise its real role in achieving economic development.; as well as the political situation and the dominance of parties and their insistence on addressing positions that have a strong relationship in managing the economic sector that has a significant impact on drawing the economic map in its current
... Show MoreThe effect of short range correlations on the inelastic longitudinal Coulomb form
factors for the lowest four excited 2+ states in 18O is analyzed. This effect (which
depends on the correlation parameter β) is inserted into the ground state charge
density distribution through the Jastrow type correlation function. The single particle
harmonic oscillator wave function is used with an oscillator size parameter b. The
parameters β and b are, considered as free parameters, adjusted for each excited state
separately so as to reproduce the experimental root mean square charge radius of
18O. The model space of 18O does not contribute to the transition charge density. As
a result, the inelastic Coulomb form factor of 18
Prediction of accurate values of residual entropy (SR) is necessary step for the
calculation of the entropy. In this paper, different equations of state were tested for the
available 2791 experimental data points of 20 pure superheated vapor compounds (14
pure nonpolar compounds + 6 pure polar compounds). The Average Absolute
Deviation (AAD) for SR of 2791 experimental data points of the all 20 pure
compounds (nonpolar and polar) when using equations of Lee-Kesler, Peng-
Robinson, Virial truncated to second and to third terms, and Soave-Redlich-Kwong
were 4.0591, 4.5849, 4.9686, 5.0350, and 4.3084 J/mol.K respectively. It was found
from these results that the Lee-Kesler equation was the best (more accurate) one
Irrigation scheduling techniques is one of the suggested solutions for water scarcity problem. The study aims to show the possibility of using practical and applicable irrigation scheduling program which was designed by Water Resources Department at the University of Baghdad by using Spreadsheet Formulas for Microsoft Excel program, version 2007, with some modification to generalize it and made it applicable to various climatic zone and different soil types, as a salvation for the shortage of irrigation water inside the irrigation projects. Irrigation projects which incidence of Tigris River basin will be taken as an applicable example. This program was based on water budgeting and programmed depending on scientific concepts which facili
... Show MoreThis paper aims at providing the teaching staff members with the necessary skills so as to become capable of tackling various situations, and treating daily problems that face students learning Spanish as a Second Language. This is made as an attempt to make teachers of foreign languages in general acquainted with modern trends of teaching with less complicated methods, specifically in teaching e earlier stages of foreign languages.
Abstracto:
En el presente trabajo pretendemos dotar al docente no nativo de Lenguas extranjeras, con algunos de los métodos necesari
... Show MoreThe research, which was drawn from his doctoral thesis (People's Policy towards Vietnam 1949-1979), discussed the roots of the connections between the Chinese and Vietnamese communists since the 1920s, the presence of Ho Chi Minh and other Vietnamese communists in China, their influence by the revolutionary struggle of the Chinese Communist Party and their establishment of a group of The Vietnamese Revolutionary Societies and the Indo-Chinese Communist Party until the outbreak of the Vietnamese Revolution and their success in declaring the establishment of the Democratic Republic of Vietnam in 1946. Keywords: Ho Chi Minh, Chinese Communist Party, Indo-Chinese Communist Party, Democratic Republic of Vietnam, Chou En Lai.
This paper introduces the Multistep Modified Reduced Differential Transform Method (MMRDTM). It is applied to approximate the solution for Nonlinear Schrodinger Equations (NLSEs) of power law nonlinearity. The proposed method has some advantages. An analytical approximation can be generated in a fast converging series by applying the proposed approach. On top of that, the number of computed terms is also significantly reduced. Compared to the RDTM, the nonlinear term in this method is replaced by related Adomian polynomials prior to the implementation of a multistep approach. As a consequence, only a smaller number of NLSE computed terms are required in the attained approximation. Moreover, the approximation also converges rapidly over a
... Show MoreThe health care provided by health institutions and all kinds suffers from many problems, and since the health services provided are related to human life, it is necessary to shed light on this activity and identify the causes of these problems. This research aims to Definition of health institutions (hospitals) Performance audit of these institutions according to the latest indicators, which are the standards of health accreditation for hospitals, specifically the basic standards issued by the Health Care Accreditation Council (HCAC) to reach the level of performance and Knowledge of Constraints that lead to in an acceptable manner consistent with the approved standards. In theoretical and practical study, a number of conclusions were r
... Show MoreA confluence of forces has brought journalism and journalism education to a precipice. The rise of fascism, the advance of digital technology, and the erosion of the economic foundation of news media are disrupting journalism and mass communication (JMC) around the world. Combined with the increasingly globalized nature of journalism and media, these forces are posing extraordinary challenges to and opportunities for journalism and media education. This essay outlines 10 core principles to guide and reinvigorate international JMC education. We offer a concluding principle for JMC education as a foundation for the general education of college students.
Throughout this paper R represents a commutative ring with identity and all R-modules M are unitary left R-modules. In this work we introduce the notion of S-maximal submodules as a generalization of the class of maximal submodules, where a proper submodule N of an R-module M is called S-maximal, if whenever W is a semi essential submodule of M with N ? W ? M, implies that W = M. Various properties of an S-maximal submodule are considered, and we investigate some relationships between S-maximal submodules and some others related concepts such as almost maximal submodules and semimaximal submodules. Also, we study the behavior of S-maximal submodules in the class of multiplication modules. Farther more we give S-Jacobson radical of ri
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