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.
This research aims to identify the reality of teaching political science research methods curriculum, to observe practices, and differences in teaching and learning between the Arab and Western universities. Moreover, it focuses on the difficulties that face students' acquisition of the course skills. The research uses the course model of some Western and Arab universities as case study.
This research shows that the curriculum do not reach yet the final form as other political science curriculums, and its upcoming changes will reflect the needs of stakeholders. The best method to teach this curriculum is to use applied learning in groups, learning by doing, and finally problem-based learning approach. Using optimal assessment deep
... Show MoreVarious visual media are becoming an increasingly important and active instrument of communication. This fact has led some political parties and leading personalities in Iraq to make use of them as an accepted forum for the discussion of public affairs usually in a manner that conforms to their declared policy. They have to draw as much popular support as they could for the causes which they fight for. As a result, a state of great confusion has been created from the contradictory statements made by the contending parties and gave left grave consequences on all types of the audience receiving them. The problem of the study can be summarized in one major question: What is the opinions of the audience as regards the statements made by the
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In the name of God, praise be to God, and prayers and peace be upon the best of God’s creation, Muhammad bin Abdullah, and upon his family and companions, and from his family:
And after:
He saw from verbs that transcend one effect if it is visual and to two effects if it is heart and this action has several strokes and it is an awareness of the sense and illusion and imagination and reason and in addition to that it has many meanings dealt with in the glossary books and as for what the verb included in the audio studies it is the explanation and deletion and slurring The heart of my place. As for what the grammatical studies included, it focuses on one or two effects according to its l
Sufficient high-quality data are unavailable to describe the management approach and guideline of COVID-19 disease in pediatric and adolescent population which may be due to mild presentation in most of cases and less severe complications than older ages.
World Health Organization was concerned with the establishment of an approved guideline to manage the increasing number of COVID-19 patients worldwide aiming to prevent or lessen COVID-19 global burden.
The clinical features have a wide spectrum starting from uncomplicated mild illness, mild-moderate pneumonia, severe pneumonia, acute respiratory distress syndrome, sepsis, septic shock, and multisystem inflammatory syndrome in children.
Many important definitions
... Show MoreTraditional accounting takes only one dimension (economic) in calculating the value added of the company, and all other aspects (including environmental and social) are neglected, and despite the emergence of Sustainability Accounting and the interest of companies in preparing sustainability reports, these reports are suffering from many problems, including multiple metrics used in measuring companies (cash, quantity and lavish). In addition, these reports may reach dozens of pages in some companies and this causes the problem (information overload) which affects the qualitative properties of accounting information such as appropriate and relative, which requires the need to find a tool that can measure the Sustainability Unit of
... Show MoreThe present work deals with five species of parasitic Hymenoptera belonging to Pteromalidae, Eupelmidae and Eurytornidae which have been reared from brachid beetles. A new species, Eurytoma irakensis is described and the species, Bruchocida orientalis Crawford is recorded for the first time from Iraq.
Modeling forward kinematics with neural networks allows for efficient handling of nonlinear relationships and realistic error correction in time-critical applications by relying on accurate training data. This paper presents a Multi-Layer Feed-Forward Neural Network (MLFFNN) to solve the forward kinematics of a 3-DOF robot. The proposed MLFFNN consists of 50 hidden neurons and was trained using 628319 samples to find only the position (x, y, z) of the end-effector. Data were generated by MATLAB, assuming an incremental motion of joints. The joint variables ( , , and ) are the inputs of the NN, which outputs the positions of the end effector (x, y, z) calculated using the Denavit-Hartenberg (DH) method. The results demonstrate that t
... Show MoreThe mediation system is based on settling the dispute amicably through the intervention of a third party by bringing views closer away from the judiciary, which is an amicable way to settle disputes, which disputants resort to voluntarily, but some Western legislation has begun to impose resorting to mediation to settle disputes compulsorily, to take advantage of its advantages, get rid of the disadvantages of resorting to the judiciary in some disputes, and relieve pressure on the courts.
Nearly a century and a half has passed since Sarah Orne Jewett published her much anthologized short story “A White Heron” (1886), but commentators on the tale missed one of the most important points in the text. It is the story’s similarity to the traditional Euro-centric fairy tale of “Little Red Riding Hood”. As an author, writing at the end of the ninetieth century, a time that witnessed the demise of the Romantic movement in America and the beginning of the age of Realism, Jewett did not romanticize her characters, despite the idyllic landscape in which “A White Heron” is set. Her story can be analyzed as a text that aims at disseminating ecological awareness among her young readers. This study focuses on Jewett
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