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.
The Purpose of this Research show gap between a Normal Cost System and Resource consumption Accounting Applied in AL-Rafidin Bank.
The Research explores that, how the idle capacity can be determined under resource consumption accounting, discuss the possibility of employing these energies. Research also viewed how costs can be separated into Committee and Attribute. Resource Consumption Accounting assists managers in pricing services or products based on what these services or products use from each Source.
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In this work , we study different chaotic properties of the product space on a one-step shift of a finite type, as well as other spaces. We prove that the product is Lyapunove –unstable if and only if at least one or is Lyapunove –unstable. Also, we show that and locally everywhere onto (l.e.o) if and only if is locally everywhere onto (l.e.o) .
A model using the artificial neural networks and genetic algorithm technique is developed for obtaining optimum dimensions of the foundation length and protections of small hydraulic structures. The procedure involves optimizing an objective function comprising a weighted summation of the state variables. The decision variables considered in the optimization are the upstream and downstream cutoffs lengths and their angles of inclination, the foundation length, and the length of the downstream soil protection. These were obtained for a given maximum difference in head, depth of impervious layer and degree of anisotropy. The optimization carried out is subjected to constraints that ensure a safe structure aga
... Show MoreIn regression testing, Test case prioritization (TCP) is a technique to arrange all the available test cases. TCP techniques can improve fault detection performance which is measured by the average percentage of fault detection (APFD). History-based TCP is one of the TCP techniques that consider the history of past data to prioritize test cases. The issue of equal priority allocation to test cases is a common problem for most TCP techniques. However, this problem has not been explored in history-based TCP techniques. To solve this problem in regression testing, most of the researchers resort to random sorting of test cases. This study aims to investigate equal priority in history-based TCP techniques. The first objective is to implement
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The reason behind choosing this topic " internal marketing (IM) of human resource management (HRM)" is to highlight the advantages of using IM in the organization framework. The problem of the research paper lies in not paying enough attention to employees genuine needs as they interact with each other in the sake of organization prosper. This research paper can be used as indictor to expose the weaknesses that the organization encounters daily. The current research paper attempts at examining the possibility of developing philosophy of internal marketing of human resources and its most practices, empowering staff, training courses, motivations and recognitions, and within departments communication, in order to reach targeted res
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An experimental study is conducted to investigate the effect of heat flux distribution on the boiling safety factor of its cooling channel. The water is allowed to flow in a horizontal circular pipe whose outlet surface is subjected to different heat flux profiles. Four types of heat flux distribution profiles are used during experiments: (constant distribution profile, type a, triangle distribution profile with its maximum in channel center, type b, triangle distribution profile with its maximum in the channel inlet, type c, and triangle distribution profile with its maximum in the channel outlet, type d). The study is conducted using heat sources of (1000 and 2665W), water flow rates of (5, 7 and 9 lit/min). The water
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In this work; copper oxide films (CuO) were fabricated by PLD. The films were analyzed by UV-VIS absorption spectra and their thickness by using profilometer. Pulsed Nd:YAG laser was used for prepared CuO thin films under O2 gas environment with varying both pulse energy and annealing temperature. The optical properties of as-grown film such as optical transmittance spectrum, refractive index and energy gap has been measured experimentally and the effects of laser pulse energy and annealing temperature on it were studied. An inverse relationship between energy gap and both annealing temperature and pulse energy was observed.
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The 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
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