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.
Granting rights, especially procedural, to victims before the International Criminal Court (ICC) is a fundamental departure from international criminal courts, whether (temporary or mixed military courts), and for the first time in the history of international criminal justice, victims can participate in reparations procedures before the Criminal Court. Where they can express their views and concerns at all stages of the proceedings, as the 1998 Rome Statute made the victim an active party in the court proceedings by recognizing a number of rights, such as the right to participate in the trial, the right to protection, and the right to legal representation, As well as the right to reparation or compensation.
In this paper we have presented a comparison between two novel integral transformations that are of great importance in the solution of differential equations. These two transformations are the complex Sadik transform and the KAJ transform. An uncompressed forced oscillator, which is an important application, served as the basis for comparison. The application was solved and exact solutions were obtained. Therefore, in this paper, the exact solution was found based on two different integral transforms: the first integral transform complex Sadik and the second integral transform KAJ. And these exact solutions obtained from these two integral transforms were new methods with simple algebraic calculations and applied to different problems.
... Show MoreАннотация
в статье рассматриваются проблемы преподавания русской литературы в иракской аудитории.. Использование литературы в преподавании иностранного языка, как правило, имеет две цели. Первая-чисто лингвистическая .. Вторая цель, однако, ассоциируется больше с экстралингвистикой и представляет собой ознакомление студентов с различными аспектами русской жизни, культуры,
... Show MoreFive samples of the ternary alloy Ge-S-Cd were created using the melting point method, and the effects of partially substituting cadmium for germanium were determined. and partial substitution of germanium by cadmium was used to study the change in electrical conductivity. Electrical experiments were performed on Ge35-xS65Cdxternary alloy with x = 0, 5, 10, 15, and 20. It was discovered that the conductivity (σdc) rises with rising temperature in all samples under experiment. This confirms that the samples have semiconductor behavior. It has been observed that there are three regions of electrical conductivity in the electrical conductivity curve at low, moderate, and high temperatures. The pr
... Show MoreIn this paper, a new class of ordinary differential equations is designed for some functions such as probability density function, cumulative distribution function, survival function and hazard function of power function distribution, these functions are used of the class under the study. The benefit of our work is that the equations ,which are generated from some probability distributions, are used to model and find the solutions of problems in our lives, and that the solutions of these equations are a solution to these problems, as the solutions of the equations under the study are the closest and the most reliable to reality. The existence and uniqueness of solutions the obtained equations in the current study are dis
... Show MoreThe present paper deals with studying the effect of electrical discharge machining (EDM) and shot blast peening parameters on work piece fatigue lives using copper and graphite electrodes. Response surface methodology (RSM) and the design of experiment (DOE) were used to plan and design the experimental work matrices for two EDM groups of experiments using kerosene dielectric alone, while the second was treated by the shot blast peening processes after EDM machining. To verify the experimental results, the analysis of variance (ANOVA) was used to predict the EDM models for high carbon high chromium AISI D2 die steel. The work piece fatigue lives in terms of safety factors after EDM models were developed by FEM using ANSY
... Show MoreBackground: There has always been a need for valuable measurements that can be used to measure hearing loss degree in patient who cannot responses to the subjective (behavioral) tests.
Objectives: to examine the accuracy of the click - Auditory Brain stem Response (ABR) test in estimating the hearing loss degree in comparison with the behavioral tests {Free Field (FF) or Pure Tone Audiometry (PTA )}.
Subjects and method: One hundred twenty one children, with suspected hearing loss, their age between 1-9 year, 51 females and 70 males were examined in this work.
Result: The relationship between the hearing loss thresholds using the behavioral
A reliability system of the multi-component stress-strength model R(s,k) will be considered in the present paper ,when the stress and strength are independent and non-identically distribution have the Exponentiated Family Distribution(FED) with the unknown shape parameter α and known scale parameter λ equal to two and parameter θ equal to three. Different estimation methods of R(s,k) were introduced corresponding to Maximum likelihood and Shrinkage estimators. Comparisons among the suggested estimators were prepared depending on simulation established on mean squared error (MSE) criteria.
The nucleon momentum distributions (NMD) and elastic electron scattering form factors of the ground state for some 1f-2p-shell nuclei, such as 58Ni, 60Ni, 62Ni, and 64Ni
isotopes have been calculated in the framework of the coherent fluctuation model (CFM) and expressed in terms of the weight function lf(x)l2 . The weight function (fluctuation function) has been related to the nucleon density distribution (NDD) of the nuclei and determined from the theory and experiment. The NDD is derived from a simple method based on the use of the single particle wave functions of the harmonic oscillator potential and the occupation numbers of the states. The feature of the l
The ground state charge, neutron and matter densities for two-neutron halo nuclei P
12
PBe
and P
14
PBe are calculated within a two- frequency shell model approach. In the description of
the halo nuclei it is important to take into account a model space for P
10
PBe and P
12
PBe different
from the two halo neutrons which have to be treated separately in order to explain their
properties. The structures of the halo P
12
PBe and P
14
PBe nuclei show that the dominant
configurations when the two halo neutrons distributed over the 1d shell orbits. Elastic
Coulomb scattering form factors of these two exotic nuclei are also studied through the
combination of the density distributions of