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 surgeryKeywords: Non-surgical treatment of anal fissure, fissure in ano, sphicterotomy,botulinum toxin in anal fissures, glyceryl trinitrate. Chemical sphincteratomy, pharmacological sphincteratomy.
Machine learning models have recently provided great promise in diagnosis of several ophthalmic disorders, including keratoconus (KCN). Keratoconus, a noninflammatory ectatic corneal disorder characterized by progressive cornea thinning, is challenging to detect as signs may be subtle. Several machine learning models have been proposed to detect KCN, however most of the models are supervised and thus require large well-annotated data. This paper proposes a new unsupervised model to detect KCN, based on adapted flower pollination algorithm (FPA) and the k-means algorithm. We will evaluate the proposed models using corneal data collected from 5430 eyes at different stages of KCN severity (1520 healthy, 331 KCN1, 1319 KCN2, 1699 KCN3 a
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إنّ التّأمّل في الدّراسات الأدبيّة النّقديّة الحديثة الّتي تنظر إلى النّصّ أنّه لوحة تتشكّل من مجموعة تداخلات نصّيّة سابقة للنصّ المُنتج أو مُعاصرة له، تدفع القارئ إلى الغوص في أعماق النّصوص وتحليلها والكشف عن الآليّات والإجراءات الّتي اعتمدت في إنتاجه، وإظهار الجماليّات الفنّيّة التي شكلت في مُجملها كائنا حيّا يُعبّر عن حالات إنسانيّة مُستمرة الحدوث رغم تقادم الأزمان.
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... Show MoreThe current research aims to recognize the exploratory and confirmatory factorial structure of the test-wiseness scale on a sample of Hama University students, using the descriptive method. Thus, the sample consists of (472) male and female students from the faculties of the University of Hama. Besides, Abu Hashem’s 50 item test-wiseness scale (2008) has been used. The validity and reliability of the items of the scale have also been verified, and six items have been deleted accordingly. The results of the exploratory factor analysis of the first degree have shown the presence of the following five acceptable factors: (exam preparation, test time management, question paper handling, answer sheet handling, and revision). Moreover,
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This study aimed to identify the role of servant leadership in promoting organizational citizenship behaviors in a sample of faculties of the University of Alqadisiya .It tried to answer several questions represented its problem.
The most important questions are the followings:
1- Is there enough perception among administrative leaders in the aforementioned faculties toward the concept of servant leadership? And under what level? &
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The influence of culture on accounting systems and practices, including financial reports and accounting information through the values identified by Gray and derived from social-cultural values, and the four accounting values were derived from generally accepted accounting principles represented by (Conservatism, Uniformity, Secrecy, and Professionalism). Important and significant in maximizing financial performance, and measuring the extent of the role of these values in improving financial performance through attention to the values of accounting culture, this research
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In this work Study effect of annealing temperature on the Structure
of a-Se and electrical properties of a-Se/c-Si hetrojunction have been
studied.The hetrojunction fabricated by deposition of a-Se film on c-
Si using thermal evaporation.
Electrical properties of a-Se/ c-Si heterojunction include I-V
characteristics, in dark at different annealing temperature and C-V
characteristics are considered in the present work.
C-V characteristics suggested that the fabricated diode was
abrupt type, built in potential determined by extrapolation from
1/C2-V curve. The built - in potential (Vbi) for the Se/ Si System
was found to be increase from 1.21 to 1.62eV with increasing of
annealing temperature
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