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.
يهدف البحث الحالي إلى اختبار العلاقة بين نوعية حياة العمل والإبداع التنظيمي في ديوان وزارة التخطيط ، ولبلوغ الهدف المذكور وبناء على معطيات البحث الاستطلاعي للباحث بني ألانموذج الفرضي للبحث الذي ضم المتغير المستقل والمعتمد، واعتماداً على حركية الأنموذج صيغت فرضيتان، ولاختبار صحة الفرضيات وجمع المعلومات من عينة البحث البالغة (100) مدير يمثلون مرك
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Experimental and numerical studies have been conducted for the effect of injected air bubbles on the heat transfer coefficient through the water flow in a vertical pipe under the influence of uniform heat flux. The investigated parameters were water flow rate of (10, 14 and 18) lit/min, air flow rate of (1.5, 3 and 4) lit/min for subjected heat fluxes of (27264, 36316 and 45398) W/m2. The energy, momentum and continuity equations were solved numerically to describe the motion of flow. Turbulence models k-ε was implemented. The mathematical model is using a CFD code Fluent (Ansys15). The water was used as continuous phase while the air was represented as dispersed. phase. The experimental work includes design, build and instrument a test
... Show MoreThe research problem stems from a chief question: “What is the nature of the responsibility that «Al-Sabah Al-Jadeed» and «Al-Mada» Newspapers have undertaken in promoting the values of citizenship and national belonging in the society? The research aims to achieve a number of goals, including: Determining the most prominent themes that were emphasized in the opinion articles in these two newspapers within the framework of the responsibility of promoting the values of citizenship and national belonging in society, and revealing the most prominent topics that were discussed in opinion articles in the two sample newspapers regarding the promotion of the mentioned values. This research is a desc
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هدفت هذه الدراسة إلى تحليل نتائج الاختبار الوطني الموحد الذي تطبقه وزارة التربية والتعليم الفلسطينية في مادة الرياضيات لطلبة الصف الثامن الأساسي في المدارس الحكومية في محافظة طولكرم، وذلك لمعرفة مستوى الطلبة على هذا الاختبار في ضوء متغيرات الجنس والمنطقة التعليمية ونوع المدرسة، ومعرفة علاقة التحصيل على هذا الاختبار بتحصيل الطلبة المدرسي والمعدل العام. ولتحقيق ذلك تم تحليل درجات (3218) طالباً وطالبة؛ وهم ي
... 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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In this paper, the complex of Lascoux in the case of partition (3,3,2) has been studied by using diagrams ,divided power of the place polarization ) (k ij ,Capelli identites and the idea of mapping Cone .
Objective: Evaluate the effects of different storage periods on flexural strength (FS) and degree of conversion (DC) of Bis-Acryl composite and Urethane dimethacrylate provisional restorative materials. Material and Methods: A total of 60 specimens were prepared from four temporary crown materials commercially available and assigned to four tested groups (n = 15 for each group): Prevision Temp, B&E CROWN, Primma Art, and Charm Temp groups. The specimens were stored in artificial saliva, and the FS was tested after 24 h, 7 d, and 14 d. A standard three-point bending test was conducted using a universal testing machine. Additionally, the DC was determined using a Fourier transform infrared spectroscopy (FTIR) device. The data were analyzed st
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The reaction of [Benzoyl hydrazine] with [Diphenyl mono oxime] and Glacial acetic acid was carried out in methanol gave a new tridentate ligand [Benzoic acid (2-hydroxyimino- 1, 2-diphyneylethylidene) - hydrazide]. This ligand was reacted with some metal ions (Fe(II), Co(II), Ni(II), and Cu(II)) in methanol with (1:1) metal : ligand ratio to give a series of new complexes of the general formula [M(L)Cl2.H2O], where M= Fe(11), Co(11), Ni(11) and Cu(11). All compounds were characterized by spectroscopic methods (I.R, UV-Vis), elemental microanalysis (C.H.N), atomic absorption, magnetic susceptibility, and conductivity measurements. From the obtained data the proposed molecular structures were suggested for the complexes of Fe
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(1)
In this paper two main stages for image classification has been presented. Training stage consists of collecting images of interest, and apply BOVW on these images (features extraction and description using SIFT, and vocabulary generation), while testing stage classifies a new unlabeled image using nearest neighbor classification method for features descriptor. Supervised bag of visual words gives good result that are present clearly in the experimental part where unlabeled images are classified although small number of images are used in the training process.
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The research aims to identify the level of educational supervisors' practices of their supervisory duties according to the requirements of comprehensive quality from the viewpoint of teachers in Oman. Moreover, identify the differences between the responses of the sample about these practices, which are attributed to gender, and years of experience. Thus, a questionnaire was administered to teachers, consisting of (48) items distributed on (5) main fields related to the educational supervisor's practices. The sample consisted of (220) teachers who were randomly chosen from the schools in Dhofar region. Data were analyzed using means, standard divisions, T-test, and One Way ANOVA. The research concluded that the level of educational super
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