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.
This paper offers a critical examination of Canadian news guidelines and policies
on user-generated content (UGC) posted on news-related comment sections and
social media.
The outline of how news-related UGC is moderated within Canadian news is achieved
by looking at the online comment policies of major Canadian news organizations like .
the CBC, CityNews (Halifax), CTV News, Glacier Media, Global News, The Globe
and Mail, Narcity Media, Postmedia, QUB (Québecor), and Torstar.The policies highlight how Canadian news organizations have practical strategies
to manage news-related UGC but also call upon positive and negative social
principles, to flag ill practices, foster democracy, and fight against online hate sp
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This research display a selected sample of Regelson's texts, there were interrelations and interactions unfolded so as to show his creativity in the employment of religious texts. In the story "In the Youth of Moses", he inter-texted the episode of the Prophet Moses from the Torah, the Source of legislation, to signify a legislative issue needed by the community. As for the story of "Samson, One of the Falling", he originated the character of The Judge Samson by alluding to the Book of the Judges, which is the Book which reminded of the defeat and slavery of the Palestinians by a Jewish leader, as is related in Jewish religious texts. Further, and the story of "And Haman Said", he chose the story of the Queen Esther from the Book of Esth
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There are Islamic sources and books that deal with the different doctrinal and differential framework of the Islamic religion with a monistic approach, describing them with embarrassing jurisprudential titles such as: excommunication and expiation, and epithets that carry the characteristics of hatred and rejection, in addition to removing them from the sect and religion, and the reason for that is that the doctrine (A) or (b) considers itself the doctrine that represents only the Islamic religion, and other doctrines are misguided and disbelieving. the reasons behind this - besides the attempt to establish doctrinal and fiqih rooting in claiming truth and escaping from within the foundational differential doctrinal system – is the pol
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Abstract
It considers training programs is an important process contributing to provide employees with the skills required to do their jobs efficiently and effectively, so it should be concerned with and the focus of all government our organizations, and perhaps the most important reasons that I was invited to select the subject (evaluation of training programs directed toward the diagnosis of the phenomenon of financial and administrative corruption) It is the importance of those programs working in the regulatory institutions General and the Office of Inspector General of Finance and the Ministry particularly for employees because of their role in the development of their skills and their experience and their beha
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Shmuel Yosef Agnon, a well-known Jewish writer, wrote many literary works, including poetry, story, etc. In the field of story, this writer used two areas: the first: a simple exterior, and the second: an inner full of secrets and mysteries. This area is common when Agnon is affected by his symbolic method of purpose. In his productions, we find the political and historical significance embodied in his characters, where there is almost no story without it.
Agnon and all his productions gave the character a large area, Agnon’s characters often play the center and cornerstone in those productions, where the author dealt deeply and stated the fines details of the external and internal of that ch
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the energy that a radiation source emits as light (photons), electromagnetic waves, or particles is known as radiation. X-ray is one type of ionizing radiation that falls within the electromagnetic wave category of short wavelengths. Because of their short wavelength. X-ray is a type of ionizing radiation that is used in a constantly growing number of diagnostic procedures. X-ray diagnostic imaging has been employed in the medical field for more than a century(Hariyoto et al., 2020). Radiation has advantages for human health, but there is also a risk. the impacts of Radiation on Fertility it is an oligospermia, or a reduction in the number of sperm cells, which is already possible after radiation exposure of 0.15 mGy. It Leads to impede
... Show MoreThe aim of the research to apply TD-ABC technology to determine the idle capacity of the central oil companies (oil field east of Baghdad), as a modern cost management technology based on time-oriented activities (TD-ABC) is used by industrial companies in general and oil companies on In particular to build a sustainable Calvinist pillar and make future decisions by identifying idle energy to gain it a competitive advantage, the descriptive analytical approach has been adopted in calculating and analyzing the company’s data for 2018, and the most prominent conclusions of this research are managing idle energy and the task of applying cost technology on the basis of time-oriented activities and providing Convenient spatial infor
... Show MoreIn this paper, a new technique is offered for solving three types of linear integral equations of the 2nd kind including Volterra-Fredholm integral equations (LVFIE) (as a general case), Volterra integral equations (LVIE) and Fredholm integral equations (LFIE) (as special cases). The new technique depends on approximating the solution to a polynomial of degree and therefore reducing the problem to a linear programming problem(LPP), which will be solved to find the approximate solution of LVFIE. Moreover, quadrature methods including trapezoidal rule (TR), Simpson 1/3 rule (SR), Boole rule (BR), and Romberg integration formula (RI) are used to approximate the integrals that exist in LVFIE. Also, a comparison between those
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The current study seeks to evaluate teacher preparation programs in the scientific disciplines at the College of Education in Al-Aqsa University in the light of the requirements of the labor market. It further aims to reveal the significance of the differences in the sample members’ response averages of to the availability of labor market requirements in the program that prepares the teacher of scientific disciplines at the Faculty of Education in Al-Aqsa University taking into account the (gender, program) variables. The study followed the descriptive analytical approach, and so a questionnaire was distributed to a sample of scientific discipline students in the teacher preparation program adopted in Al-Aqsa University, (200) male and
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