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.
يتكون الانحدار المقسم من عدة أقسام تفصل بينها نقاط انتماء مختلفة، فتظهر حالة عدم التجانس الناشئة من عملية فصل الأقسام ضمن عينة البحث. ويهتم هذا البحث في تقدير موقع نقطة التغيير بين الأقسام وتقدير معلمات الأنموذج، واقتراح طريقة تقدير حصينة ومقارنتها مع بعض الطرائق المستعملة في الانحدار الخطي المقسم. وقد تم استعمال أحد الطرائق التقليدية (طريقة Muggeo) لإيجاد مقدرات الإمكان الأعظم بالأسلوب الت
... Show MoreThe objective of the investigation was to analyze the structure and administration of the political system in Iraq (post-ISIS). After 2003, the Iraqi political system suffered the fundamental problem of its failure to achieve the political and social inclusion that characterizes democratic systems, to guarantee the establishment of a "state for all", while respecting differences. Political representation has moved from the system of sectarian ethnic components, under the title of consensual democracy, to the representation of leaders and the realization of their interests and the interests of their parties at the expense of the groups that claim to represent them, which complicates the problem. In this sense, the new political syste
... Show MoreThis paper aims at providing the teaching staff members with the necessary skills so as to become capable of tackling various situations, and treating daily problems that face students learning Spanish as a Second Language. This is made as an attempt to make teachers of foreign languages in general acquainted with modern trends of teaching with less complicated methods, specifically in teaching e earlier stages of foreign languages.
Abstracto:
En el presente trabajo pretendemos dotar al docente no nativo de Lenguas extranjeras, con algunos de los métodos necesari
... Show MoreThis paper introduces the Multistep Modified Reduced Differential Transform Method (MMRDTM). It is applied to approximate the solution for Nonlinear Schrodinger Equations (NLSEs) of power law nonlinearity. The proposed method has some advantages. An analytical approximation can be generated in a fast converging series by applying the proposed approach. On top of that, the number of computed terms is also significantly reduced. Compared to the RDTM, the nonlinear term in this method is replaced by related Adomian polynomials prior to the implementation of a multistep approach. As a consequence, only a smaller number of NLSE computed terms are required in the attained approximation. Moreover, the approximation also converges rapidly over a
... Show MoreWeibull distribution is considered as one of the most widely distribution applied in real life, Its similar to normal distribution in the way of applications, it's also considered as one of the distributions that can applied in many fields such as industrial engineering to represent replaced and manufacturing time ,weather forecasting, and other scientific uses in reliability studies and survival function in medical and communication engineering fields.
In this paper, The scale parameter has been estimated for weibull distribution using Bayesian method based on Jeffery prior information as a first method , then enhanced by improving Jeffery prior information and then used as a se
... Show MoreThe research, which was drawn from his doctoral thesis (People's Policy towards Vietnam 1949-1979), discussed the roots of the connections between the Chinese and Vietnamese communists since the 1920s, the presence of Ho Chi Minh and other Vietnamese communists in China, their influence by the revolutionary struggle of the Chinese Communist Party and their establishment of a group of The Vietnamese Revolutionary Societies and the Indo-Chinese Communist Party until the outbreak of the Vietnamese Revolution and their success in declaring the establishment of the Democratic Republic of Vietnam in 1946. Keywords: Ho Chi Minh, Chinese Communist Party, Indo-Chinese Communist Party, Democratic Republic of Vietnam, Chou En Lai.
Segmented regression consists of several sections separated by different points of membership, showing the heterogeneity arising from the process of separating the segments within the research sample. This research is concerned with estimating the location of the change point between segments and estimating model parameters, and proposing a robust estimation method and compare it with some other methods that used in the segmented regression. One of the traditional methods (Muggeo method) has been used to find the maximum likelihood estimator in an iterative approach for the model and the change point as well. Moreover, a robust estimation method (IRW method) has used which depends on the use of the robust M-estimator technique in
... Show MoreThe effect of short range correlations on the inelastic longitudinal Coulomb form
factors for the lowest four excited 2+ states in 18O is analyzed. This effect (which
depends on the correlation parameter β) is inserted into the ground state charge
density distribution through the Jastrow type correlation function. The single particle
harmonic oscillator wave function is used with an oscillator size parameter b. The
parameters β and b are, considered as free parameters, adjusted for each excited state
separately so as to reproduce the experimental root mean square charge radius of
18O. The model space of 18O does not contribute to the transition charge density. As
a result, the inelastic Coulomb form factor of 18
Rock engineers widely use the uniaxial compressive strength (UCS) of rocks in designing
surface and underground structures. The procedure for measuring this rock strength has been
standardized by both the International Society for Rock Mechanics (ISRM) and American Society
for Testing and Materials (ASTM), Akram and Bakar(2007).
In this paper, an experimental study was performed to correlate of Point Load Index ( Is(50))
and Pulse Wave Velocity (Vp) to the Unconfined Compressive Strength (UCS) of Rocks. The effect
of several parameters was studied. Point load test, Unconfined Compressive Strength (UCS) and
Pulse Wave Velocity (Vp) were used for testing several rock samples with different diameters.
The predicted e
The estimation of the parameters of linear regression is based on the usual Least Square method, as this method is based on the estimation of several basic assumptions. Therefore, the accuracy of estimating the parameters of the model depends on the validity of these hypotheses. The most successful technique was the robust estimation method which is minimizing maximum likelihood estimator (MM-estimator) that proved its efficiency in this purpose. However, the use of the model becomes unrealistic and one of these assumptions is the uniformity of the variance and the normal distribution of the error. These assumptions are not achievable in the case of studying a specific problem that may include complex data of more than one model. To
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