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.
The category of those who agree with the phrase: The Environment and Life Program warns me of the environmental damages resulting from the issue of using black oil in electrical generators in residential neighborhoods came first, with a high rate of 81.4%. With the environment, the public always turns to the public broadcasting service and its programs to provide knowledge so that it can avoid it. Thus, the respondents' attitude towards this issue was positive.
The m-consecutive-k-out-of-n: F linear and circular system consists of n sequentially connected components; the components are ordered on a line or a circle; it fails if there are at least m non-overlapping runs of consecutive-k failed components. This paper proposes the reliability and failure probability functions for both linearly and circularly m-consecutive-k-out-of-n: F systems. More precisely, the failure states of the system components are separated into two collections (the working and the failure collections); where each one is defined as a collection of finite mutual disjoint classes of the system states. Illustrative example is provided.
Inferential methods of statistical distributions have reached a high level of interest in recent years. However, in real life, data can follow more than one distribution, and then mixture models must be fitted to such data. One of which is a finite mixture of Rayleigh distribution that is widely used in modelling lifetime data in many fields, such as medicine, agriculture and engineering. In this paper, we proposed a new Bayesian frameworks by assuming conjugate priors for the square of the component parameters. We used this prior distribution in the classical Bayesian, Metropolis-hasting (MH) and Gibbs sampler methods. The performance of these techniques were assessed by conducting data which was generated from two and three-component mixt
... Show MoreThis paper adapted the neural network for the estimating of the direction of arrival (DOA). It uses an unsupervised adaptive neural network with GHA algorithm to extract the principal components that in turn, are used by Capon method to estimate the DOA, where by the PCA neural network we take signal subspace only and use it in Capon (i.e. we will ignore the noise subspace, and take the signal subspace only).
Maxim Gorky’s Mother is one of the most important literary genre in social realism, in which he depicts female characters with revolutionary fervor and enthusiasm, projecting his social ideologies and dreams. Though the novel unique importance lies in the fact that it has been thoroughly analyzed by many writers, historians and sociologists, there are almost no studies devoted to the role of women out of a Marxist and feminist point of view. The present paper sheds light on the Russian woman‘s important role in overcoming all adversity and gain her position on Social Realism.
Одно из центральных мест сре
... Show MoreAccurate predictive tools for VLE calculation are always needed. A new method is introduced for VLE calculation which is very simple to apply with very good results compared with previously used methods. It does not need any physical property except each binary system need tow constants only. Also, this method can be applied to calculate VLE data for any binary system at any polarity or from any group family. But the system binary should not confirm an azeotrope. This new method is expanding in application to cover a range of temperature. This expansion does not need anything except the application of the new proposed form with the system of two constants. This method with its development is applied to 56 binary mixtures with 1120 equili
... Show MoreThe most frequently diagnosed condition in women at the age of reproduction is the polycystic ovarian syndrome (PCOS).it could be related to a complex endocrine condition, due to its heterogeneity and uncertainty about its etiology, as the clinical highlights of PCOS incorporate those related to reproductive signs such as decreased frequency of ovulation, irregular menstrual cycles, decreased fertility. Carnitine plays a substantial role in weight loss, glucose tolerance, insulin function and fatty acid metabolism. Thus carnitine plays a crucial role in controlling obesity, insulin resistance, oxidative stress that are associated with PCOS .While, AGEs are a diverse group of reactive molecules that are formed end
... Show MoreThis study reported the investigation of the Radio Frequency (RF) signal propagation of Global System for Mobile Communications (GSM) coverage in Emmanuel Alayande College of Education (EACOED), Oyo, Oyo State, Nigeria. The study aims at amplifying the quality of service and augment end users' sensitivity of the wireless services operation. The drive test method is adopted with estimation of coverage level and received signal strength. The Network Cell Info Lite application installed in three INFINIX GSM mobile phones was employed to take the measurement of the signal strength received from the transmitting stations of different mobile networks. The results of the study revealed that MTN has the maximum signal strength with a mean value
... Show MoreThe current research aims to determine the requirements of Trends of International Mathematics and Science Study (TIMSS 2019) and to find out the extent to which the content of science textbooks for grades (1-4) in the Sultanate of Oman includes the requirements of (TIMSS 2019). Only the Cognitive Process dimension has been considered when conducting the analysis. The study population includes all science books from the first to the fourth grade for the academic year 2021-2022. The study identified and organized the requirements in the study tool, which is a list of requirements of (TIMSS 2019). After confirming its validity and reliability, the analysis was performed, and data were collected and analyzed statistically using frequencies
... Show MoreThis research aims to identify the role of external environment factors on the quality of educational services, from the academic point of view, where the distribution of a questionnaire to a random sample of (100) university professors, and then analyzing a model, and test the validity of this model using structural modeling (SEM) (Structural Equation Modeling).
And then test the relationships between variables using the software of Statistical Package for Social Sciences (SPSS V.18), the research found a number of conclusions, the most important conclusion is: the external environment factors has significant impact on the quality of educational services.