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 importance of research and study of classical Persian literature is not overlooked. So far, there have been many studies in this area. But there are still some things that need more research. Persian grammar is one of the most important branches of Persian literature. This section has always been converted at different times. One of the issues that has been neglected in the studies of classical literature is the study of the technical tales of past and past poetry. These texts can be studied from different perspectives. Because Persian is a mixed language, it is possible to combine language terms with each other or to add prefixes and suffixes to express new concepts. They can be used by exam
... Show Morethe 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 MoreThere 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 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.
The 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
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There is no doubt that the achievement of the manuscripts of There is no doubt various of situations for performing a duty , The diversity of stimuli in humans with sensory, unconscious and instinct sensitive systems. Which leads to a diversity of feelings, sensations, emotions and feelings, This therefore requires different types of function linguistic structures indication , Of that linguistic potential that God willing to be unique, In the function of discharging and venting those feelings and emotions that are raised by its various stimuli, which are only needs and psychological and biological purposes require verification and access and gain it. S
... Show MoreThis 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
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