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.
Human Interactive Proofs (HIPs) are automatic inverse Turing tests, which are intended to differentiate between people and malicious computer programs. The mission of making good HIP system is a challenging issue, since the resultant HIP must be secure against attacks and in the same time it must be practical for humans. Text-based HIPs is one of the most popular HIPs types. It exploits the capability of humans to recite text images more than Optical Character Recognition (OCR), but the current text-based HIPs are not well-matched with rapid development of computer vision techniques, since they are either vey simply passed or very hard to resolve, thus this motivate that
... Show MoreThe research is concerned with studying the characteristics of Sustainable Architecture and Green Architecture, as a general research methodology related to the specific field of architecture, based on the differentiation between two generic concepts, Sustainability and Greening, to form the framework of the research specific methodology, where both concepts seem to be extremely overlapping for research centers, individuals, and relevant organizations. In this regard, the research tend towards searching their characteristics and to clearly differentiates between the two terms, particularly in architecture, where the research seeks understanding sustainable and green architectures, how they are so close or so far, and the
... Show MoreThis paper presents the intricate issues and strategies related to the translation of children's books, and it particularly focuses on the comparative analysis of "The Tale of Peter Rabbit" by Beatrix Potter and "Le Petit Prince" (The Little Prince) by Antoine de Saint-Exupéry. The study finds that the typical problems in translation are, idiomatic expressions, cultural reference, and the voice preservation, along side-sheet-specific challenges which each of the text faces. The translator of Potter's work should have skills of transposing all culturally oriented peculiarities of the UK land to the international audience to keep it accessible. On the contrary, "Le Petit Prince" translation will be the process of capturing the abstra
... Show MoreThis paper proposes a self organizing fuzzy controller as an enhancement level of the fuzzy controller. The adjustment mechanism provides explicit adaptation to tune and update the position of the output membership functions of the fuzzy controller. Simulation results show that this controller is capable of controlling a non-linear time varying system so that the performance of the system improves so as to reach the desired state in a less number of samples.
The Caputo definition of fractional derivatives introduces solution to the difficulties appears in the numerical treatment of differential equations due its consistency in differentiating constant functions. In the same time the memory and hereditary behaviors of the time fractional order derivatives (TFODE) still common in all definitions of fractional derivatives. The use of properties of companion matrices appears in reformulating multilevel schemes as generalized two level schemes is employed with the Gerschgorin disc theorems to prove stability condition. Caputo fractional derivatives with finite difference representations is considered. Moreover the effect of using the inverse operator which tr
The researchers of the present study have conducted a genre analysis of two political debates between American presidential nominees in the 2016 and 2020 elections. The current study seeks to analyze the cognitive construction of political debates to evaluate the typical moves and strategies politicians use to express their communicative intentions and to reveal the language manifestations of those moves and strategies. To achieve the study’s aims, the researchers adopt Bhatia’s (1993) framework of cognitive construction supported by van Emeren’s (2010) pragma-dialectic framework. The study demonstrates that both presidents adhere to this genre structuring to further their political agendas. For a positive and promising image
... Show MoreThis study explores the semiotic aspects of American slang, specifically focusing on the phenomenon of reduplicative expressions in informal speech. Despite the extensive research on American slang, limited attention has been given to the cultural and mythical meanings embedded within reduplicative expressions. To address this gap, the study investigates how these expressions convey denotative, connotative, and mythical meanings within casual American discourse. The objectives of the study include: 1. To what extent does Barthes’ semiotic model hold potential for application in this study? 2. How are reduplicative slang expressions widely used in everyday American life? 3. To what extent do qualitative and quantitative methods hav
... Show MoreThis research provides a new method to study praise poetry that can be used as a course to teach English and Arabic to students in the College of Education. This research answers two questions:
- Is it possible to examine praise poetry as a tagmeme?
- Is this analysis of great help in teaching English and Arabic to students in the College of Education?
The data that will be chosen for the purpose of analysis are two of Shakespeare's sonnets and two of AL Mulik's poems. The sonnets selected for this purpose are 17 and 18. AL Mulik's poems selected for the same purpose are 8 and 9.
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