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.
Political Discourse Analysis is an important linguistic study approach used by politicians to gain people support. The present paper sheds light on the figures of speech of emphasis in the televised debate between the two presidential elections candidates, Emmanuel Macron and Marine Le Pen and the distinctive effect they add to the political discourse to win general public support as well as the presidential elections.
The present paper provides a rudimentary definition and an analysis of the terms “discourse” and “political discourse” and traces the significant role played by politically directed televised Media and internet to support political pa
... Show MoreIn this study, a system of nonthermal plasma that was operated under atmospheric pressure and was powered by argon gas was employed. The particular plasma properties are affected by changes in the Ar gas flow ranges from 0.5 to 2.5 l/min, product by stream of the plasma jet that is utilized. By using the aforementioned method generated from AC and DC. After placing Ar gas as the cathode, which represents the negative pole, flows toward the anode, which is represented by a tiny metal plate of Zn measuring 6 × 1 cm2 in size, with a submerged part of 4 cm2 long, with both types of current employed having a high voltage of 13.5 kV and the frequency of AC was 30 kHz, we measured these variable parameters. It has been shown that when argon f
... Show MoreThis research includes the use of an artificial intelligence algorithm, which is one of the algorithms of biological systems which is the algorithm of genetic regulatory networks (GRNs), which is a dynamic system for a group of variables representing space within time. To construct this biological system, we use (ODEs) and to analyze the stationarity of the model we use Euler's method. And through the factors that affect the process of gene expression in terms of inhibition and activation of the transcription process on DNA, we will use TF transcription factors. The current research aims to use the latest methods of the artificial intelligence algorithm. To apply Gene Regulation Networks (GRNs), we used a progr
... Show Moreتهدف هذه الدراسة للتعرف على السياسات اإلاسرائيلية المتبعة على الارض والمتمثلة في االاستيطان
الاستعماري والطرق التفافية، ومصادرة الاراضي وجدار الضم والتوسع العنصري، بالاضافة إلى التصنيف
الاداري للمناطق في الضفة الغربية حسب ما جاء في اتفاقية أوسلو، والتي من شأنها التأثير على تلك
المناطق، وال سيما قطاع اإلسكان الذي يعد من أهم القطاعات التي تتر كب وبالتحديد في منطقة الدراسة،
وسوف تحاول هذه الدراسة تس
Let G be a graph, each edge e of which is given a weight w(e). The shortest path problem is a path of minimum weight connecting two specified vertices a and b, and from it we have a pre-topology. Furthermore, we study the restriction and separators in pre-topology generated by the shortest path problems. Finally, we study the rate of liaison in pre-topology between two subgraphs. It is formally shown that the new distance measure is a metric
The national educational systems both in the Russian Federation and Iraq Republic have to adjust the training programs to duly prepare the pedagogical university students for the modern challenges and situations on the market of educational services. For success of the service, the education specialists have to fully mobilize their physical, mental and emotional resources and persistently advance their skills and knowledge using the relevant online education courses; practical research conferences; persistent self-education to master theoretical fundamentals of the modern physical education and sport service; and be active in trainings and competitions in their vocational individual game sports including badminton, table tennis and tennis.
... Show MoreLet R be a commutative ring with identity and E be a unitary left R – module .We introduce and study the concept Weak Pseudo – 2 – Absorbing submodules as generalization of weakle – 2 – Absorbing submodules , where a proper submodule A of an R – module E is called Weak Pseudo – 2 – Absorbing if 0 ≠rsx A for r, s R , x E , implies that rx A + soc ( E ) or sx A + soc (E) or rs [ A + soc ( E ) E ]. Many basic properties, char
... Show MoreDespite the significant increase in public spending in Iraq, it was not directed toward the important sectors that have an important role in correcting the productive structure. Rather, most of the public expenditure was going to cover the required imports, or to face shocks, whether security or health, and this caused a continuous decrease in the volume of Iraq's exports of goods and services, as the aim of the study was to review the importance of public debt and its impact on the trade balance, as well as to know the economic policies that can contribute to strengthening the trade balance, as the study proved through the (ARDL) model that there is a direct relationship between the domestic debt and the net trade balance, and an invers
... Show MoreThe purpose and goal of the research revolve around the diagnosis of intellectual capital as the logical indicator to study an effective human resource management practice and its influential role in determining the overall quality management of higher education institutions and scientific research in Baghdad.
To achieve the purpose of the research, an upgraded standard questionnaire was used to collect data and distribute it to the selected sample in a statistical manner from the study population of (5) institutions affiliated with the Ministry of Higher Education and Scientific Resear
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