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.
This literary review addresses the status of the most famous Israeli writer, Amos Oz, through the analysis of relevant articles that highlight various aspects of his literary and political orientations, reflecting his ideological and social background. Oz's literature encompasses a mix of political orientations that many critics view as extreme, while others see them as moderate stances indicative of the author's awareness. And these are what strengthened his literary status in modern Hebrew literature.These trends emphasized the contribution of Oz's works to shaping Israeli cultural consciousness and reflect the challenges facing identity in multiple contexts. He was an advocate for equality between Palestinians and Israelis and
... Show Morethe contemporary Arab scholars deal with semiotics as an approach that helps them understand the texts, its meaning, and its structural functionalism . that’s why every now and then we find some
studies and researches using semiotics as an approach in study and comparatives, some of them even used the semiotic approach in analyzing old and new texts, while others think that semiotic holds and important place in critical approaches .
even though some of them considers semiotic just a trend of fashion this really didn’t lessen the value of semiotic as a scientific and procedural approach in literary and media studies as well as in analyzing literary and journalistic texts. for this reason it is considered as an important approa
In this paper the research introduces a new definition of a fuzzy normed space then the related concepts such as fuzzy continuous, convergence of sequence of fuzzy points and Cauchy sequence of fuzzy points are discussed in details.
Maintaining and breeding fish in a pond are a crucial task for a large fish breeder. The main issues for fish breeders are pond management such as the production of food for fishes and to maintain the pond water quality. The dynamic or technological system for breeders has been invented and becomes important to get maximum profit return for aquaponic breeders in maintaining fishes. This research presents a developed prototype of a dynamic fish feeder based on fish existence. The dynamic fish feeder is programmed to feed where sensors detected the fish's existence. A microcontroller board NodeMCU ESP8266 is programmed for the developed h
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In this paper, a new third kind Chebyshev wavelets operational matrix of derivative is presented, then the operational matrix of derivative is applied for solving optimal control problems using, third kind Chebyshev wavelets expansions. The proposed method consists of reducing the linear system of optimal control problem into a system of algebraic equations, by expanding the state variables, as a series in terms of third kind Chebyshev wavelets with unknown coefficients. Example to illustrate the effectiveness of the method has been presented.
A simple, sensitive and rapid method was used for the estimate of: Propranolol with Bi (III) to prove the efficiency, reliability and repeatability of the long distance chasing photometer (NAG-ADF-300-2) using continuous flow injection analysis. The method is based on a reaction between propranolol and Bi (III) in an aqueous medium to obtain a yellow precipitate. Optimum parameters were studied to increase the sensitivity for the developed method. A linear range for calibration graph was 0.1-25 mmol/L for cell A and 1-40 mmol/L for cell B, and LOD 51.8698 ng/200 µL and 363.0886 ng /200 µL , respectively to cell A and cell B with correlation coefficient (r) 0.9975 for cell A, 0.9966 for cell B, RSD% was lower than 1%, (n = 8) for the
... Show MoreMalaysia has been supported by one of the high-speed fiber internet connections called TM UniFi. TM UniFi is very familiar to be used as a medium to apply Small Office Home Office (SOHO) concept due to the COVID-19 pandemic. Most of the communication vendors offer varieties of network services to fulfill customers' needs and satisfaction during the pandemic. Quality of Services is queried by most users by the fact of increased on users from time to time. Therefore, it is crucial to know the network performance contrary to the number of devices connected to the TM UniFi network. The main objective of this research is to analyze TM UniFi performance with the impact of multiple device connections or users' services. The study was conducted
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Background: Job satisfaction remains as an important concern for both employer and employee. A high-quality teaching staff is the cornerstone of a successful educational system. One step in developing a high quality faculty understands the factors associated with teaching quality and retention. One of these factors is job satisfaction, which has been studied widely by organizational researchers.Objectives: To evaluate the extent of job satisfaction of teaching staff working at AL-Kindy College of medicine and to identify some work-related factors associated with job satisfaction.Methods: A cross- sectional study was carried out. A convenient sample of 50 teaching staff, who had a teaching job at different scientific departments at AL-Kin
... Show MoreAn experimental analysis was included to study and investigate the mass transport behavior of cupric ions reduction as the main reaction in the presence of 0.5M H2SO4 by weight difference technique (WDT). The experiments were carried out by electrochemical cell with a rotating cylinder electrode as cathode. The impacts of different operating conditions on mass transfer coefficient were analyzed such as rotation speeds 100-500 rpm, electrolyte temperatures 30-60 , and cupric ions concentration 250-750 ppm. The order of copper reduction reaction was investigated and it shows a first order reaction behavior. The mass transfer coefficient for the described system was correlated with the aid of dimensionless groups as fo
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