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.
Perhaps the issue of media and the press, especially one of the most common topics that people deliberate and deal with permanently and continuously. An issue of such significance has pushed researchers to put the following question, “Is it possible to live without media?”, “Can people ignore the newspaper, radio, TV, or the other communication means?”
The answer is very simple. It is difficult for civilized society to overtake information, or dispense with circulation, at the individual or collective level. Yet, the question of how to make the media and how it determines its content still requires extensive media experience; and knowledge of the social structure and its relations; and ac
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Receipt date:2/17/2021 acceptance date:3/16/2021 Publishing date:12/31/2021
This work is licensed under a Creative Commons Attribution 4.0 International License.
Objective: This paper investigates the contradictions in the decision-making process of the United States, which historically proven to be successful policies in the short term, but in the long term proven to be wanting and failure. Methodology: The paper uses descriptive, historical, comparative method. A
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Maximum likelihood estimation method, uniformly minimum variance unbiased estimation method and minimum mean square error estimation, as classical estimation procedures, are frequently used for parameter estimation in statistics, which assuming the parameter is constant , while Bayes method assuming the parameter is random variable and hence the Bayes estimator is an estimator which minimize the Bayes risk for each value the random observable and for square error lose function the Bayes estimator is the posterior mean. It is well known that the Bayesian estimation is hardly used as a parameter estimation technique due to some difficulties to finding a prior distribution.
The interest of this paper is that
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Imagination as a Path to Reality
Discriminant between groups is one of the common procedures because of its ability to analyze many practical phenomena, and there are several methods can be used for this purpose, such as linear and quadratic discriminant functions. recently, neural networks is used as a tool to distinguish between groups.
In this paper the simulation is used to compare neural networks and classical method for classify observations to group that is belong to, in case of some variables that don’t follow the normal distribution. we use the proportion of number of misclassification observations to the all observations as a criterion of comparison.
Most Internet-tomography problems such as shared congestion detection depend on network measurements. Usually, such measurements are carried out in multiple locations inside the network and relied on local clocks. These clocks usually skewed with time making these measurements unsynchronized and thereby degrading the performance of most techniques. Recently, shared congestion detection has become an important issue in many computer networked applications such as multimedia streaming and
peer-to-peer file sharing. One of the most powerful techniques that employed in literature is based on Discrete Wavelet Transform (DWT) with cross-correlation operation to determine the state of the congestion. Wavelet transform is used as a de-noisin
This research is about the resources and the way of al-Waqidi in his
researching of al-sira of the Prophet. And what happened in the first of Islam.
This research is about the documents which al-Waqidi had it. Some of it,
which he had visited, was the places, especially the periods which the events had took
place in. He was asking those whom were contemporary to the happenings, from the
sons of al-Sahaba and al-Tabi’een.
Also this research is lightening on the new studies that gave this historian a
good respect during his work, in which he could gave the reality about his authorship.
The research is trying to draw real way of al-Waqidi and what were reported by him,
especially the documents, and what he had s
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Endoscopy is a rapidly growing field of Neurosurgery, it is defined as the applying of endoscope to treat different conditions of brain pathology within cerebral ventricular system and beyond it, endoscopic procedures performed by using different equipment and recording system to make a better visualization enhancing the surgeon's view by increasing illumination and magnification to look around corner and to capture image on video or digital format for later studies.
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