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.
Let G be a graph, each edge e of which is given a weight w(e). The shortest path problem is a path of minimum weight connecting two specified vertices a and b, and from it we have a pre-topology. Furthermore, we study the restriction and separators in pre-topology generated by the shortest path problems. Finally, we study the rate of liaison in pre-topology between two subgraphs. It is formally shown that the new distance measure is a metric
Soft closure spaces are a new structure that was introduced very recently. These new spaces are based on the notion of soft closure operators. This work aims to provide applications of soft closure operators. We introduce the concept of soft continuous mappings and soft closed (resp. open) mappings, support them with examples, and investigate some of their properties.
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تهدف هذه الدراسة للتعرف على السياسات اإلاسرائيلية المتبعة على الارض والمتمثلة في االاستيطان
الاستعماري والطرق التفافية، ومصادرة الاراضي وجدار الضم والتوسع العنصري، بالاضافة إلى التصنيف
الاداري للمناطق في الضفة الغربية حسب ما جاء في اتفاقية أوسلو، والتي من شأنها التأثير على تلك
المناطق، وال سيما قطاع اإلسكان الذي يعد من أهم القطاعات التي تتر كب وبالتحديد في منطقة الدراسة،
وسوف تحاول هذه الدراسة تس
Let R be a commutative ring with identity and E be a unitary left R – module .We introduce and study the concept Weak Pseudo – 2 – Absorbing submodules as generalization of weakle – 2 – Absorbing submodules , where a proper submodule A of an R – module E is called Weak Pseudo – 2 – Absorbing if 0 ≠rsx A for r, s R , x E , implies that rx A + soc ( E ) or sx A + soc (E) or rs [ A + soc ( E ) E ]. Many basic properties, char
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In this paper, we introduce new definitions of the - spaces namely the - spaces Here, and are natural numbers that are not necessarily equal, such that . The space refers to the n-dimensional Euclidean space, refers to the quaternions set and refers to the N-dimensional quaternionic space. Furthermore, we establish and prove some properties of their elements. These elements are quaternion-valued N-vector functions defined on , and the spaces have never been introduced in this way before.
Despite the significant increase in public spending in Iraq, it was not directed toward the important sectors that have an important role in correcting the productive structure. Rather, most of the public expenditure was going to cover the required imports, or to face shocks, whether security or health, and this caused a continuous decrease in the volume of Iraq's exports of goods and services, as the aim of the study was to review the importance of public debt and its impact on the trade balance, as well as to know the economic policies that can contribute to strengthening the trade balance, as the study proved through the (ARDL) model that there is a direct relationship between the domestic debt and the net trade balance, and an invers
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The purpose and goal of the research revolve around the diagnosis of intellectual capital as the logical indicator to study an effective human resource management practice and its influential role in determining the overall quality management of higher education institutions and scientific research in Baghdad.
To achieve the purpose of the research, an upgraded standard questionnaire was used to collect data and distribute it to the selected sample in a statistical manner from the study population of (5) institutions affiliated with the Ministry of Higher Education and Scientific Resear
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Being the meeting points of the world different languages and out of a scholarly perspective, comparative literature represents a cultural leap as well as an artistic and intellectual development or a global literary movement of both prose and poetry. Such homogenous literary structure requires a systematic and coherent study of the literary output of the people different cultures and civilizations. It also represents the theoretical approach of the present study that debates a systematic comparison between Ghassan Kanafani’s All That's Left to You and William Faulkner’s. The Sound and the Fury. Within the perspective of the descriptive analysis approach, the present paper discusses th
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This research aims to knowledge of the scope of applying the international specification of which is regarded to occupational health and safety management system (OHSAS 18001) second edition for year 2007 by The AL-Mammon Factory / The General Company For Vegetable Oils Industry in order to diagnosis the gap between specification requirements and reality by using the checklist made based upon the items of the specification, after translating the English copy into Arabic. The results of the research and analysis that occupational health and safety management system in comparison to the specification requirements in all of its main items, which was (%22.26) applied and documented partly, this refer to the existence of great gap (%7
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