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.
Abstract:
The research aims to monitor the image of the man in the group (The Cart and the Rain) by the storyteller (Badiaa Amin); With the aim of highlighting an aspect of feminist writing, especially with regard to the relationship of women to men, and determining the form adopted by the storyteller in drawing the features of men.
The research used the descriptive-analytical method in the space of its textual formation, which aims to stand on the text and deconstruct its narrative significance. To provide a comprehensive picture of it.
Three images of the man appeared in the group's stories, represented by (the authoritarian, the negative, and the positive), and the image of the authoritarian ma
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In order to understand the effect of (length of pile / diameter of pile) ratio on the load carrying capacity and settlement reduction behavior of piled raft resting on loose sand, laboratory model tests were conducted on small-scale models. The parameters studied were the effect of pile length and the number of piles. The load settlement behavior obtained from the tests has been validated by using 3-D finite element in ABAQUS program, was adopted to understand the load carrying response of piled raft and settlement reduction. The results of experimental work show that the increase in (Lp/dp) ratio led to increase in load carrying capacity by piled raft from (19.75 to 29.35%), (14.18 to 28.87%) and (0 to 16.49%) , the maximum load carried
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Athletics are different from other games as a competition between individuals to show their competence and physical ability to achieve new record numbers in the various activities and various between the boards, jumping and throwing and each type of these activities in particular performance so found the researcher to find the method of training resistors in the development of special power and achievement In the effectiveness of javelin, where the researchers chose the sample of the athletes from the specialized school of athletics to effectively throw the spear at the ages of 15-17 years and carried out the tests of the research, which includes the strength of the speed of the arms and explosive power and The various resistance exercise
... Show MoreThe size and the concentration of the gold nanoparticles (GNPs)
synthesized in double distilled deionized water (DDDW) have been
found to be affected by the laser energy and the number of pulses.
The absorption spectra of the nanoparticles DDDW, and the
surface plasmon resonance (SPR) peaks were measured, and found to
be located between (509 and 524)nm using the UV- Vis
spectrophotometer. SPR calculations, images of transmission
electron microscope, and dynamic light scattering (DLS) method
were used to determine the size of GNPs, which found to be ranged
between (3.5 and 27) nm. The concentrations of GNPs in colloidal
solutions found to be ranged between (37 and 142) ppm, and
measured by atomic absorptio
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Stream of Consciousness technique has a great impact on writing literary texts in the modern age. This technique was broadly used in the late of nineteen century as a result of thedecay of plot, especially in novel writing. Novelists began to use stream of consciousness technique as a new phenomenon, because it goes deeper into the human mind and soul through involving it in writing. Modern novel has changed after Victorian age from the traditional novel that considers themes of religion, culture, social matters, etc. to be a group of irregular events and thoughts interrogate or reveal the inner feeling of readers.
This study simplifies stream of consciousness technique through clarifying the three levels of conscious
... Show MoreThe integration of arti cial intelligence (AI), whether through devices or software, has become a critical tool in analyzing and evaluating technical performance. AI signi cantly contributes to enhancing athletic performance by enabling accurate data analysis and supporting educators in developing effective training programs and interactive curricula. This study addresses a noticeable gap in the literature regarding the attitudes and inclinations of educators toward AI in physical education and sport sciences—a gap often attributed to limited awareness and lack of access to moderntechnologies.Theprimaryaimofthestudyistoexaminethetendenciesandperceptionsoffemaleinstructorsin physical education and sport sciences toward the use of AI
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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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Abstract
This study aims to identify the repercussions of the Corona pandemic (Covid 19) and its impact on the educational and psychological functions of the Omani family from the point of view of a number of fathers and mothers. Drive for a group of fathers and mothers, some of whom work in the government sector and others are mothers enrolled in graduate studies programs at the university, their ages range between (30-50 years) totally (28) mothers and fathers: 22 mothers and 6 fathers. The results showed that the repercussions of the transformation of e-learning, home quarantine, social distancing, and the challenges associated with them were among the most frequent responses that posed a real challenge to the
... Show MoreThis 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
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