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.
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This study explores the language used in reporting political headlines conducting a rhetorical stylistic analysis. It is based on showing the effect of the rhetorical stylistic relations in news reporting. The aim is to investigate the structure adopted in reporting political news. It argues that the rhetorical stylistic devices are necessary and applicable to non-literary texts, i.e. political headlines to evaluate language use in the representation of non-literary texts. The analysis was carried out on data selected from the British broadsheet The Guardian and the American New York Times newspaper headlines. The data were examined and subjected to a contrastive analysis incorporating rhetorical and stylistic tools to discern h
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Background: Nursing interventions tailored to the smoking triggers in patients with non-communicable chronic diseases are essential. However, these interventions are scant due to the nature of factors associated with smoking cessation and the poor understanding of the effect of nurse-led intervention in Iraq.Purpose: This study aimed to determine the dominant smoking triggers and examine the effects of a tailored nursing intervention on smoking behavior in patients with non-communicable chronic diseases.Methods: Convenience samples of 128 patients with non-communicable chronic diseases, male and female patients, who were 18-70 years old, were recruited in this quasi-experimental, randomized comparative trial in the outpatient clinic
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KE Sharquie, MM Al-Waiz, AA Al-Nuaimy, Saudi medical journal, 2002 - Cited by 11
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The Wang-Ball polynomials operational matrices of the derivatives are used in this study to solve singular perturbed second-order differential equations (SPSODEs) with boundary conditions. Using the matrix of Wang-Ball polynomials, the main singular perturbation problem is converted into linear algebraic equation systems. The coefficients of the required approximate solution are obtained from the solution of this system. The residual correction approach was also used to improve an error, and the results were compared to other reported numerical methods. Several examples are used to illustrate both the reliability and usefulness of the Wang-Ball operational matrices. The Wang Ball approach has the ability to improve the outcomes by minimi
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Purpose: The research seeks to develop the implications of intellectual human capital, and social capital in business organizations, and will be accomplished on three levels, the first level (the level of description) to identify, diagnose and display content philosophical Strategic Human Resource Management at the thought of modern administrative represented by human capital and Ras social capital. The second level (level of analysis) and the analysis of the extent of the impact of alignment between human capital, and social capital in the organizational strength of the organizations. The third level (Level predict) the formulation of a plan to strengthen the organizational strength in business organizations and to develop speci
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Back ground: The innervations of the pineal
gland from the superior cervical ganglion have
shown some form of a chromatolysis reaction.
Objective:
1-Tracing the innervations of the pineal gland by
removing the target tissue (the pineal gland in
this study) i.e. (pinealoctomy) and removal of the
superior cervical ganglion i.e. (ganglionectomy).
2- The localization and total number of the
neurons which project into the rat pineal gland
3-The effect of pinealoctomy on the SCG after a
different time interval.
Methods: Twenty five albino rats were used in
this study, Pinealoctomy was done, then after a
different time interval ganglionectomy was done,
in order to study the Chromatolysis in their cel
Numeral recognition is considered an essential preliminary step for optical character recognition, document understanding, and others. Although several handwritten numeral recognition algorithms have been proposed so far, achieving adequate recognition accuracy and execution time remain challenging to date. In particular, recognition accuracy depends on the features extraction mechanism. As such, a fast and robust numeral recognition method is essential, which meets the desired accuracy by extracting the features efficiently while maintaining fast implementation time. Furthermore, to date most of the existing studies are focused on evaluating their methods based on clean environments, thus limiting understanding of their potential a
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Background: Nursing interventions tailored to the smoking triggers in patients with non-communicable chronic diseases are essential. However, these interventions are scant due to the nature of factors associated with smoking cessation and the poor understanding of the effect of nurse-led intervention in Iraq.Purpose: This study aimed to determine the dominant smoking triggers and examine the effects of a tailored nursing intervention on smoking behavior in patients with non-communicable chronic diseases.Methods: Convenience samples of 128 patients with non-communicable chronic diseases, male and female patients, who were 18-70 years old, were recruited in this quasi-experimental, randomized comparative trial in the outpatient clinic
... Show More
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