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.
Praise be to Allah, Lord of the Worlds, teach the pen, taught the human what he didn't know, Ihmad - Almighty - and thank him, and repent to him and ask forgiveness, which is the most forgiving, and bear witness that there is no god but Allah alone has no partner, gives and prevents, And I bear witness that Muhammad is a slave to Allah and his Messenger, who called for guidance and good speech and spoke, peace be upon him and his family and companions, and those who followed them until the Day of Judgment.
This study is marked by: The ignorant poem and body language
Its main objective is to reveal the manifestations of this language in the text mentioned, and accordingly, the sieve poem has been read semantic (semantic) and hermeneutic, revealing the poet's ability to employ symbols and signals (body language) in the poem chosen for this purpose; The existence of such language in pre-Islamic poetry. After a long reflection and reading, the signs and symbols of the physical movement of the body, and its feminine and aesthetic manifestations were identified, and this was achieved through the use of modern critical methodologies that directly affect this language. The study consisted of an introduction and three topics, followed by t
Idiomatic expressions in Russian journalism make one important borrowed means for making a dialogue with the receiver's intellect in so far as it has the distinct feature of having clarity and exactness of meaning. The meaning is seen as a shortcut for covering a series of concepts and details so as to arrive at the intended meaning. This is done by stimulating the reader by the use of certain clear idioms. The use of such idioms in a journalistic text is not for a linguistic purpose only, but it is a cultural and social phenomenon reflecting the type of current changes in the society and it aims at discoursing with the reader's mind. This paper is a practi
... Show MoreAfter completion of the artistic production, the artist plays the echo of this production upon the recipient. Whether this recipient is from the public, art connoisseurs, or private artists, critics and academics. In the past, the boundaries of Time and place had a great effect in limiting this echo or its quality, as the views of the recipients were largely influenced by the prevailing thought or the artistic trends that dominate the artistic scene in the surrounding environment in which the artist created. In order for the artist to show works for the widest segment of the recipient, he bears the burden of the costs of transporting the work, a keeper of damage on the move, and the material amounts that may hinder the publication of the
... Show MoreThe aim of this study is to identify the effectiveness of a rational, emotional, behavioral program in developing self-efficacy to reduce the level of Burnout in 20 teachers of students with autism disorder in Jazan, Saudi Arabia. The proposed program included 12 training sessions. The researcher found that the proposed program has contributed significantly to the development of self-efficacy and reduce the level of Burnout for the targeted subject in this study.
Background:Sun protection is one of the most important steps of skin care as it is necessary to protect the skin from ultraviolet rays that is known to cause number of harmful effects on the skin in long and frequent exposure. Objective:To assess the awareness of the medical students regarding sun exposure and its harm,study their sun protection attitudes,practices, their use of sunscreens, and to know if they can share information to other people to encourage such important protective methods and behaviours which are not well established in our community.Patients and method:This cross-sectional descriptive study included 300 students both females and males of fourth and fifth grade of College of Medicine in university of Baghdad.Results:M
... Show MoreBN Rashid, Ajes: Asian Journal of English Studies, 2013
In this paper, membrane-based computing image segmentation, both region-based and edge-based, is proposed for medical images that involve two types of neighborhood relations between pixels. These neighborhood relations—namely, 4-adjacency and 8-adjacency of a membrane computing approach—construct a family of tissue-like P systems for segmenting actual 2D medical images in a constant number of steps; the two types of adjacency were compared using different hardware platforms. The process involves the generation of membrane-based segmentation rules for 2D medical images. The rules are written in the P-Lingua format and appended to the input image for visualization. The findings show that the neighborhood relations between pixels o
... Show MoreThe combination of wavelet theory and neural networks has lead to the development of wavelet networks. Wavelet networks are feed-forward neural networks using wavelets as activation function. Wavelets networks have been used in classification and identification problems with some success.
In this work we proposed a fuzzy wavenet network (FWN), which learns by common back-propagation algorithm to classify medical images. The library of medical image has been analyzed, first. Second, Two experimental tables’ rules provide an excellent opportunity to test the ability of fuzzy wavenet network due to the high level of information variability often experienced with this type of images.
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