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 the era of the digital economy, public organizations need to consolidation the capabilities of entrepreneurial alertness to reduce the risks of sudden transformations and changes, and to find effective mechanisms to discover and invest in environmental opportunities proactively, as this concern has become a knowledge gap in public sector institutions, the current research aims to identify the role of digital competence in influencing on entrepreneurial alertness in the Central Bank of Iraq (CBI), the descriptive analytical approach was used as a research method to describe and analyze the main research variables. digital competence as an explanatory variable includes three dimensions: digital infrastructure, digital integration, and d
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Here, we found an estimation of best approximation of unbounded functions which satisfied weighted Lipschitz condition with respect to convex polynomial by means of weighted Totik-Ditzian modulus of continuity
This paper presents an IoT smart building platform with fog and cloud computing capable of performing near real-time predictive analytics in fog nodes. The researchers explained thoroughly the internet of things in smart buildings, the big data analytics, and the fog and cloud computing technologies. They then presented the smart platform, its requirements, and its components. The datasets on which the analytics will be run will be displayed. The linear regression and the support vector regression data mining techniques are presented. Those two machine learning models are implemented with the appropriate techniques, starting by cleaning and preparing the data visualization and uncovering hidden information about the behavior of
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Abstract Infinitives and gerunds are non-finite verb forms which cannot be indicated by tense, number, or person. The construction of non-finite verbs is intricate because of their nature of meanings, forms, and functions. The major problem is that both infinitival and gerundial complements have identical functions and occupy identical positions in the sentences. Thus, there is a confusion in using an infinitival and gerundial forms after aspectual verbs. The selection of either one of these two forms as complements is controlled syntactically or semantically. Moreover, both forms can be used usually with similar predicate but with neat difference in meaning. In addition, there are problems with controlling the use of aspect, since aspectua
... Show MoreIn this research , we study the inverse Gompertz distribution (IG) and estimate the survival function of the distribution , and the survival function was evaluated using three methods (the Maximum likelihood, least squares, and percentiles estimators) and choosing the best method estimation ,as it was found that the best method for estimating the survival function is the squares-least method because it has the lowest IMSE and for all sample sizes
Summary:This article discusses the topic of phraseological units with the names of wild animals in the Russian and Arabic languages in the aspect of their comparative semantic and cultural analysis, since a comparative analysis of the meanings of phraseological units of the Arabic and Russian languages, detection of coincidences and differences in the compared languages, is an important method for studying linguoculturology, since phraseological units represent a reflection of culture in the language
A field experiment is conducted to study the effect of different levels of peat (0, 25, 50, 75, and 100 Mg ha-1 to uncropped and cropped soil to wheat. Soil samples are taken in different period of time (0, 3, 30, 60, 90, 120, and 180 days after cultivation to determine (NaHCO3-Exteractable P at 3 different depths (0-10, 10-20, and 20-30 cm). Field Experiment is conducted in a randomized complete block design (RCBD) with four replicates. Wheat, Al-Rasheed variety, is cultivated as a testing crop. The entire field is equally dived in two divisions. One of the two divisions is cultivated to wheat and the second is left uncropped. The effect of five levels of peat namely 0, 25, 50, 75, 100 Mg ha-1 is investigated. Soils are fully analyzed
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Four hundred and fifty urine samples were collected from patients suffering from urinary tract infection from the General Azadi hospital in Kurkuk province ,during the period of october 2007 till march 2008 . Results of bacteriological culture revealed that (168) out of (450) studied samples (37.3%) gave positive culture using blood agar and macConkey agar ; different species of bacterial isolates were detected using morphological and biochemical tests ,from these isolates the highest percentage of the isolates were from Escherichia coli when it was (100) isolates out of (190) isolate (52.63%) . one hundred isolates were distributed between (77) from females and (23) from
... Show MoreIn this paper, the packing problem for complete ( 4)-arcs in is partially solved. The minimum and the maximum sizes of complete ( 4)-arcs in are obtained. The idea that has been used to do this classification is based on using the algorithm introduced in Section 3 in this paper. Also, this paper establishes the connection between the projective geometry in terms of a complete ( , 4)-arc in and the algebraic characteristics of a plane quartic curve over the field represented by the number of its rational points and inflexion points. In addition, some sizes of complete ( 6)-arcs in the projective plane of order thirteen are established, namely for = 53, 54, 55, 56.
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