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.
A stylistic study in the poetry of Hafiz Ibrahim, praise be to God, Lord of the worlds, and prayers and peace be upon his best messengers, and the seal of his prophets, Muhammad and his good and pure family, and after ...
The poet Hafez Ibrahim is considered one of the well-known poets in the modern era, and his language was distinguished by sobriety, eloquence in expressions, and beautiful meanings And he had my journey in the study of his poetry a stylistic study, and the research came with an introduction in which the concept of stylistics was briefly explained, since it was studied by many researchers, then divided the research into three topics: I studied in the first the construction of the poem, and I stood at the most importan
This work proposes a new video buffer framework (VBF) to acquire a favorable quality of experience (QoE) for video streaming in cellular networks. The proposed framework consists of three main parts: client selection algorithm, categorization method, and distribution mechanism. The client selection algorithm was named independent client selection algorithm (ICSA), which is proposed to select the best clients who have less interfering effects on video quality and recognize the clients’ urgency based on buffer occupancy level. In the categorization method, each frame in the video buffer is given a specific number for better estimation of the playout outage probability, so it can efficiently handle so many frames from different video
... Show MoreThe right to property is one of the most fundamental rights enjoyed by individuals, and most national constitutions and laws, as well as international conventions, have to be respected and protected only in accordance with the economic and social development of the country (the so-called public benefit) and in return for just compensation. What is fair compensation?
We introduce a new class of harmonici multivalent functions define by generalized Rucheweyh derivative operator. We also obtain several interesting propertiesi such as sharp coefficienit estimates, distortioni bound, extreme points, Hadamardi product and other several results. Derivative; extreme points.
Notes are given regarding new record species of the braconid parasite short note in Iraq. That is Apanteles angalcti it is found to parasitize early larval instaxs of Ectomyslois ceratontae, one of the most serious pests of pomegra- nate fruit.
War as a human phenomenon, has its own literature. Poetry is a major genre in this literature. This paper is an attempt to investigate and analyse some stylistic features in two selected, English and Arabic, war poems. These poems share the same theme.Both promote the principle of sacrificing one’s own life for the sake of homeland. This paper limits itself to analyse, thecontent words, tenses, semantic grouping of vocabulary and foregrounding in the two poems. The areas of analysis show great similarities in distributing the general content words (nouns, verbs, adjectives, and adverbs). In the analysis of the semantic areas of each content word, these poems reveal some similarities and some differences in their frequency rates.
... Show MoreThere is no adopt in the importance of the optical communications in scientific civil and military applications because of it’s simplicity in manufacturing and it's low cost. The method of optical communication depends upon bearing the light beam the translated informations by a method called the light modulation. This method depends upon changing some light properties as frequency, amplitude and pulse duration according to the translating informations. The changes in the first two properties are concerned optically with the analog modulation while the third one concern at most with digital modulation. All past methods are expensive with low efficiency and needs electrical or magnetic fields. In this technique the source of voice used
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