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.
The current environment is witnessing several developments as a result of the changes taking place in all areas of economic, social , political and legal that led to the transformation of the industrial economy , which depends based on quantitative production to a knowledge economy which relies based on information and knowledge , as the central pillar of this economy during the trading of these information and knowledge between all individuals in general and decision makers , in particular, through information and communication technology of computers and the Internet to achieve sustainable human development in the social dimension. &
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studied, and its important properties and relationship with both closed and open Nano sets were investigated. The new Nano sets were linked to the concept of Nano ideal, the development of nano ideal mildly closed set and it has been studied its properties. In addition to the applied aspect of the research, a sample was taken from patients infected with viral hepatitis, and by examining the infected people and using closed and open (nano mildly. and nano ideal mildly) sets, the important symptoms that constitute the core of this dangerous examining the infected people and using closed and open (nano mildly. and nano ideal mildly) sets, the important symptoms that constitute the core of this dangerous disease.
The main purpose of this work is to introduce some types of fuzzy convergence sequences of operators defined on a standard fuzzy normed space (SFN-spaces) and investigate some properties and relationships between these concepts. Firstly, the definition of weak fuzzy convergence sequence in terms of fuzzy bounded linear functional is given. Then the notions of weakly and strongly fuzzy convergence sequences of operators are introduced and essential theorems related to these concepts are proved. In particular, if ( ) is a strongly fuzzy convergent sequence with a limit where linear operator from complete standard fuzzy normed space into a standard fuzzy normed space then belongs to the set of all fuzzy bounded linear operators
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It is a common Knowledge that adverbs in Turkish languages can modify verbs, adjectives, nouns or other adverbs. Moreover, adverbs can determine the meanings of nouns and verbs in a sentence as far as time, place, manner, quantity and interrogative are concerned. The present study debates adverbs’ functions in Namiq Kamal’s play Vatan yahut Silistre.
The study sheds light on the author’s use of the adverbs to describe the required theatrical actions of the play and to convey his reflections and thoughts easily to the auidence. One of the main hindrances encountered in conducting the study is the shortage of the upto date academic resources necessary for
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In this paper, some relations between the flows and the Enveloping Semi-group were studied. It allows to associate some properties on the topological compactification to any pointed flows. These relations enable us to study a number of the properties of the principles of flows corresponding with using algebric properties. Also in this paper proofs to some theorems of these relations are given.
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The Disi water samples were collected from different Disi aquifer wells in Jordan using a clean polyethylene container of 10-liter size. A hyper-pure germanium (HPGe) detector with high- resolution gamma-ray spectroscopy and a low background counting system was used for the identification of unknown gamma-rays emitting from radionuclides in the environmental samples. The ranges of specific activity concentrations of 226Ra and 228Ra in the Disi aquifer water were found to be from 0.302 ± 0.085 to 0.723 ± 0.207 and from 0.047 ± 0.010 to 0.525 ± 0.138 Bq L−1, with average values of 0.516 ± 0.090 and 0.287 ± 0.091 Bq L−1, respectively. The average combined radium (226Ra + 228Ra) activity and radium activity ratio (228Ra/226Ra) in Disi
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The utilization of artificial intelligence techniques has garnered significant interest in recent research due to their pivotal role in enhancing the quality of educational offerings. This study investigated the impact of employing artificial intelligence techniques on improving the quality of educational services, as perceived by students enrolled in the College of Pharmacy at the University of Baghdad. The study sample comprised 379 male and female students. A descriptive-analytical approach was used, with a questionnaire as the primary tool for data collection. The findings indicated that the application of artificial intelligence methods was highly effective, and the educational services provided to students were of exceptional quality.
... Show MoreBackground: As photochemical reaction that can stiffen the cornea, CXL is the only promising method of preventing progression of keratectasia such as KC and secondary ectasia following refractive surgery. The aim of CXL is to stabilize the underlying condition with a small chance of visual improvement. Objective: To show the sequences of changes in visual acuity and topographic outcomes during 1 year post CXL for patients with progressive Keratoconus.Type of the study: Cross sectional studyMethods: CXL procedure was done for 45 eyes with progressive KC. The following parameters had been monitored pre operatively, 1, 3, 6 and 12 months postoperatively: K apex, K2, corneal thickness at thinnest location, anterior and posterior elevation po
... Show MoreIn this paper we study the selection of cognitive elements and criteria of the inflectional structure of the Russian and Arabic languages in the process of speech communication. Phonetic-physiological principle is the main parameter by which the elements and criteria of cognitive activity in the presented study are distinguished. On the basis of the above mentioned parameter, we select the investigated criteria and elements. The first criterion is semantic, reflects the accordance of the elements of thinking to sound combinations in the studied languages, and allows us to distinguish the second criterion – morphonological. The second criterion depends on the phonetic changes of these combinations occurring in the process of speech activit
... Show MoreThe study seeks to identify e-governance requirements in human resources management, which are (administrative requirements, technical, human, financial, and security) which is a new style differs from the traditional management pattern, where work depends on multiple forms and methods of Tools, (e. g. computers and various electronic software), by relying on powerful information systems that help to make management decisions as quickly and less effortless and less expensive to keep up with the tremendous technological advancements in the field of information and communication technology revolution.
The sample included 132 Person who constitute a position (Director General, assistant Director General, section managers and d
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