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.
In 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
... Show MoreWe introduce in this paper the concept of approximaitly semi-prime submodules of unitary left -module over a commutative ring with identity as a generalization of a prime submodules and semi-prime submodules, also generalization of quasi-prime submodules and approximaitly prime submodules. Various basic properties of an approximaitly semi-prime submodules are discussed, where a proper submodule of an -module is called an approximaitly semi-prime submodule of , if whenever , where , and , implies that . Furthermore the behaviors of approximaitly semi-prime submodule in some classes of modules are studied. On the other hand several characterizations of this concept are
... Show More"The aim of the research is to identify the availability of the dimensions of the research variables represented by organizational symmetry and the quality of work-life at the University of Information and Communications Technology, which is one of the formations of the Ministry of Higher Education and Scientific Research in Baghdad, in addition to knowing the relationship and influence between them. The research relied on the descriptive analytical approach based on peer description. The research was analyzed and the research sample consisted of (148) individuals, the sample was chosen using the comprehensive inventory method, data was obtained by relying on the questionnaire which was prepared from ready-made m
... Show MoreLet R be a commutative ring with unity and an R-submodule N is called semimaximal if and only if
the sufficient conditions of F-submodules to be semimaximal .Also the concepts of (simple , semisimple) F- submodules and quotient F- modules are introduced and given some properties .
The article considers semantic and stylistic motivations for using obsolete lexicon (historicisms) in the text of a work of art. The specifics of the functioning of this process are presented against the background of the features of the contemporary Russian literary language. Attention is focused on the fact that the layer of obsolete lexical units belongs to a number of nationally specific vocabulary, the development of which forms an understanding of the nature of the actualized language. In addition, it should be noted that the semantics of historicisms is culturally commensurate: the latter is explained by the fact that the deactuation of linguistic units is positioned as parallel to the sociocultural and political changes.
... Show MoreTraining has an effect on employees’ performances. Accordingly, the person who is responsible for employees’ development must figure out the most effective way to train and develop employees. Central Michigan University (CMU) has recognized the importance of providing appropriate training for employees who have a duty in advising students. The reason is that these employees have a significant impact on students’ educational performances. Thus, special attention to this category of employees is needed to improve advising quality. This research attempted to explore the impact of training on academic advising at CMU. Face-to-face interviews and online surveys were used as data collection tools for this study. The study scope c
... Show MorePolitical 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 MoreThe intensification of competition among all companies and at different levels has become necessary for every company need to continue to improve its performance in order to be able to face the competition and stay in the market. To achieve this, we must rely on the company's accounting information more accurate and appropriate and provided in a timely manner, for the purpose of use in planning and decision making.
So there must be information systems that help the administration to continuous development and improvement of the performance of companies in general, and this is what you need Jordanian companies, especially after the accession of Jordan to the field
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