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 surgery Keywords: Non-surgical treatment of anal fissure, fissure in ano, sphicterotomy,botulinum toxin in anal fissures, glyceryl trinitrate. Chemical sphincteratomy, pharmacological sphincteratomy.
Contemporary Media Stylistics permits readers to explore a variety of methodological applications to data analysis. Recent developments in technology and media communication provide linguists and stylisticians with authentic data for analysis based on real-life communication.
A comprehensive review focuses on 3D network-on-chip (NoC) simulators and plugins while paying attention to the 2D simulators as the baseline is presented. Discussions include the programming languages, installation configuration, platforms and operating systems for the respective simulators. In addition, the simulator’s properties and plugins for design metrics evaluations are addressed. This review is intended for the early career researchers starting in 3D NoC, offering selection guidelines on the right tools for the targeted NoC architecture, design, and requirements.
Kriging, a geostatistical technique, has been used for many years to evaluate groundwater quality. The best estimation data for unsampled points were determined by using this method depending on measured variables for an area. The groundwater contaminants assessment worldwide was found through many kriging methods. The present paper shows a review of the most known methods of kriging that were used in estimating and mapping the groundwater quality. Indicator kriging, simple kriging, cokriging, ordinary kriging, disjunctive kriging and lognormal kriging are the most used techniques. In addition, the concept of the disjunctive kriging method was explained in this work to be easily understood.
Physical measurements are one of the basic factors that affect the performance of the goalkeeper, especially when confronting fixed kicks that require special skills such as the reaction and accuracy in concentration, and with technological development artificial intelligence has become an effective tool for analyzing mathematical data that is difficult to discover in traditional methods The study aims to employ techniques Artificial intelligence to study the relationship between physical measurements and the accuracy of confronting the fixed kicks of goalkeepers in football. This study will contribute to providing a deeper understanding of physical factors that affect the performance of goalkeepers, in addition to designing dedicat
... Show MoreA large number of natural or synthetic dyes have been removed from both national and international lists of permitted food colors because of their mutagenic or carcinogenic activity. Therefore, this study aimed to use the Random Amplified Polymorphic DNA-Based Polymerase Chain Reaction (RAPD-PCR) assay as a feasible method to evaluate the ability of some food colors as genotoxin-induced DNA damage and mutations. Lactiplantibacillus plantarum was used as a bioindicator to determine the genotoxic effects by RAPD-PCR using M13 primer after treatment with some synthetic dyes currently used as food color additives, including Sunset Yellow, Carmoisine, and Tartrazine. Besides qualitative analysis, the bioinformatic GelJ software was used for clus
... Show MoreObjectives: The study objectives are to determine the impact of education program upon the academic nurses'
practice concerning documentation of nursing sheets, and to find out the relationship between nurses knowledge
and their demographic characteristics, which include age, sex, and years of experience in medical and surgical
wards.
Methodology: A quasi- experimental study was carried out at the medical and surgical wards in teaching
hospitals in Sulaimani governorate from the beginning of March up to June 2007٠
To reach the objectives of the study anon-probability (purposive) sample of (25) academic nurses who work in
the medical and surgical wards in teaching hospitals.
The data were collected through the use
The research is based on a statement of the effect and nature of the relationship of elements of promotional mix represented by (advertising, personal selling, sales promotion, public relations and direct marketing) as the independent variable in the dependent variable represented in the competitive advantage in the General Company for the manufacture of medicines and medical supplies Samarra. Analytical descriptive in the theoretical side, through the use of a number of literature from scientific sources (books, research and studies published in Arab and foreign magazines) was also relied on the methodology of the case study in the practical side, Data collection using the questionnaire tool, which was designed using the triangular Like
... Show MoreThe issue of nuclear proliferation is one of the most vital issues as it reflects a form of dealing in the field of international relations. Therefore, the Middle East region has taken great interest in reducing the levels of nuclear armament and acquiring nuclear power within the strategic framework of the international and regional powers. The establishment of a nuclear-weapon-free zone in the Middle East region is currently one of the most important international and regional arrangements for controlling the levels of nuclear proliferation and attempting to build a state of stability and balance. In the Middle East and the world. The importance of the research comes from the fact that it deals with an important and vital issue
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