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 tackles tragedy and grief in the Hebrew poetry of the Middle Ages, as being topics which was transferred to it from Arabic poetry at that time. This came as a result of Hebrew poets quoting images from, and adopting the form and content of the Arabic poem. So, this topic was a prominent feature in the Hebrew poetry of the middle ages. The Hebrew poets focused upon this topic along three trends: poems of lamentation, whether being what are called national lamentation where poets expressed their feelings and grieves because of their remoteness and longing to their homeland, which is Palestine or the sacred land, as they claim; here, Zionist trends were apparent in many poems lamenting Zion and other cities. The other type of poe
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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
... Show MoreThis 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
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
... Show MoreThis study aims at identifying the reality of alternative assessment for teachers of the first cycle of the basic education in the Sultanate of Oman with respect to the degree of teachers' use of alternative assessment strategies, level of self-efficacy for alternative assessment strategies, and attitude towards alternative assessment, and their relationship with other variables. To achieve the aims of the study, a descriptive research approach was utilized. A 5-point self-rated questionnaire was developed. It consists of three sections: Actual use of alternative assessment strategies (21 items), self-efficacy for alternative assessment strategies (21 items), and attitude towards alternative assessment (27 items). The psychometric proper
... Show MoreThe study aimed to reveal the degree of inclusion of media concepts in the books of social and national studies in general education in light of the criteria of media education and the nature of the Saudi society. Additionally, to identify the estimations of the participants in the study of the importance of including media concepts in these books, and to build a matrix of the range and sequence of media concepts in the books of social and national studies in the grades of Saudi general education. The study followed the descriptive approach in both descriptive analysis of the textbooks and descriptive survey of the study participants who were (203) students in the schools of boys and girls in general education in Makkah. The study used t
... Show MoreThis 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
... Show MoreThe Research Aims To Clarify The Role Of Knowledge Innovation On The Administrative Process Represented by Managing Strategic Momentum, The Research Problem Focuses on Administrative leader Interest In And Implementation Of The Innovation Element Of Knowledge In The Organization By " Managing Strategic Momentum" As Well As The Focus By Management About The Innovators And Makers Of Knowledge And Strategic Planners In The Design And Formulation Of Strategic. Research does Contribute In Solving Part Of The Organizational Problems Of Vision, Innovation And Their Impact On The Momentum Management To Determine The Extent On Which The Procedures Of The Assessed Companies And Plan To Regulate Innovation Under The Momentu
... Show MoreThe deployment of UAVs is one of the key challenges in UAV-based communications while using UAVs for IoT applications. In this article, a new scheme for energy efficient data collection with a deadline time for the Internet of things (IoT) using the Unmanned Aerial Vehicles (UAV) is presented. We provided a new data collection method, which was set to collect IoT node data by providing an efficient deployment and mobility of multiple UAV, used to collect data from ground internet of things devices in a given deadline time. In the proposed method, data collection was done with minimum energy consumption of IoTs as well as UAVs. In order to find an optimal solution to this problem, we will first provide a mixed integer linear programming m
... Show MoreRoughness length is one of the key variables in micrometeorological studies and environmental studies in regards to describing development of cities and urban environments. By utilizing the three dimensions ultrasonic anemometer installed at Mustansiriyah university, we determined the rate of the height of the rough elements (trees, buildings and bridges) to the surrounding area of the university for a radius of 1 km. After this, we calculated the zero-plane displacement length of eight sections and calculated the length of surface roughness. The results proved that the ranges of the variables above are ZH (9.2-13.8) m, Zd (4.3-8.1) m and Zo (0.24-0.48) m.