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.
Most of the Weibull models studied in the literature were appropriate for modelling a continuous random variable which assumes the variable takes on real values over the interval [0,∞]. One of the new studies in statistics is when the variables take on discrete values. The idea was first introduced by Nakagawa and Osaki, as they introduced discrete Weibull distribution with two shape parameters q and β where 0 < q < 1 and b > 0. Weibull models for modelling discrete random variables assume only non-negative integer values. Such models are useful for modelling for example; the number of cycles to failure when components are subjected to cyclical loading. Discrete Weibull models can be obta
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Euphemism is an important linguistic phenomenon that tends to soften written or oral expressions. Thus, when translators or interpreters face expressions including euphemism, they need to know how to deal with them. The problem of the current paper lies in the effect of rendering euphemistic expressions inaccurately, as such expressions represent the cultural and terminological sense of the original language. Thus, rendering them improperly will affect the sense of the interpreted speech. For this, it is essential for translators in general and simultaneous interpreters in particular to know the importance of utilizing euphemism in the simultaneous interpreting field, which is the main aim of this paper. To this end, a systematic review
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The present study aims to illuminate the assessment of the Turkish elite of the role of the Turkish media in forming the attitudes of public opinion vis a vis the attempted military coup of 15 July 2016. The authors utilized the survey method of a nominal sample of 315 individuals, equally distributed among the three foremost categories of the Turkish elite, namely: the political academic, and media elite. The foremost findings of the study are that the orientation of the coverage of the Turkish media of the events of the attempt military coup of 15 July, based on the perception and assessment of the Turkish elite, was positive to a high degree; it refuted the news and the inciting information given to foreign media revealed the bloodine
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The effects of solar radiation pressure at several satellite (near Earth orbit satellite, low Earth orbit satellite, medium Earth orbit satellite and high Earth orbit satellite ) have been investigated. Computer simulation of the equation of motion with perturbations using step-by-step integration (Cowell's method) designed by matlab a 7.4 where using Jacobian matrix method to increase the accuracy of result.
In this research we assumed that the number of emissions by time (𝑡) of radiation particles is distributed poisson distribution with parameter (𝑡), where < 0 is the intensity of radiation. We conclude that the time of the first emission is distributed exponentially with parameter 𝜃, while the time of the k-th emission (𝑘 = 2,3,4, … . . ) is gamma distributed with parameters (𝑘, 𝜃), we used a real data to show that the Bayes estimator 𝜃 ∗ for 𝜃 is more efficient than 𝜃̂, the maximum likelihood estimator for 𝜃 by using the derived variances of both estimators as a statistical indicator for efficiency
The Islamic Issue did not rise the “widespread arguments” in contemporary times, just as the issue of applying Islamic Law. Just as the Islamic forces used this purpose, or employed it during their march to reach to power by adopting the sacred as motivation towered the power, or control the governance. However, the reality show that this goal remained within the boundaries of slogans in the sense of a teleological slogan, and did not go beyond the limits of advocacy or arrangement as the primary source of legislation with differences of teleological reasoning, in a manner that reflected an intellectual problem about the validity of the use of this concept or the ability to apply and enforce the law in today's world, to impose
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This study aims to deliver the woman’s image and to unveil on how to be introduced in the TV series. The research is based on the survey method-using content analysis tool. The research sample represented in the TV series produced by the IMN, which were displayed in 2014 and used the pattern of Margaret Gallagher to analyze the content of the series in accordance with the frame analysis theory.
The study came up with declination of the woman’s representation compared with man in Iraqi TV drama, also the study finds that the series introduced the woman according to the personal, social, political, and economic frames in a standardizing method. It focuses on the characteristics always attributed to it as showing her obedient of the
In this paper the oscillation criterion was investigated for all solutions of the third-order half linear neutral differential equations. Some necessary and sufficient conditions are established for every solution of (a(t)[(x(t)±p(t)x(?(t) ) )^'' ]^? )^'+q(t) x^? (?(t) )=0, t?t_0, to be oscillatory. Examples are given to illustrate our main results.
Abstract\
Dealing economic units at the present time with an industrial environment characterized by competitiveness and the pace of change and its strength as a result of this changing environment shall be on those who made it to adopt strategies that allow them to confront these variables and work in order to meet the market requirements of quality and price appropriate products to suit and the demand for those products and conditions to maintain
its competitive position and its development.
As a result, it became the subject of competitiveness in recent years and enjoys widespread attention at the global level. And in order to keep up
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The dispersion relation of linear quantum ion acoustic waves is derivate according to a fluid approach that depends on the kinetic description of the systems of charged particles model. We discussed the dispersion relation by changing its parameters and graphically represented. We found through graphs that there is full agreement with previous studies on the subject of interest. That motivates us to discuss the dispersion relation of waves depending on the original basic parameters that implicitly involved in the relationship which change the relationship by one way or another, such as electron Fermi temperature and the density at equilibrium state.