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 paper aims at providing the teaching staff members with the necessary skills so as to become capable of tackling various situations, and treating daily problems that face students learning Spanish as a Second Language. This is made as an attempt to make teachers of foreign languages in general acquainted with modern trends of teaching with less complicated methods, specifically in teaching e earlier stages of foreign languages.
Abstracto:
En el presente trabajo pretendemos dotar al docente no nativo de Lenguas extranjeras, con algunos de los métodos necesari
... Show MoreAnaemia is a common extra-articular manifestation of rheumatoid arthritis (RA) where anaemia of chronic disease (ACD) and iron deficiency anaemia (IDA) are the two most frequent types. The distinction between these two types of anaemia has always been challenging requiring sophisticated techniques. Serum transferrin receptor (sTfR) a truncated soluble form of the transferrin receptor is one of the parameters that is influenced by the Iron content and supply to the erythrons and is not affected by inflammatory status and therefore the use of the sTfR/log ferritin (sTfR-F) index can be a reliable indicator of functional iron deficiency.
This paper introduces the Multistep Modified Reduced Differential Transform Method (MMRDTM). It is applied to approximate the solution for Nonlinear Schrodinger Equations (NLSEs) of power law nonlinearity. The proposed method has some advantages. An analytical approximation can be generated in a fast converging series by applying the proposed approach. On top of that, the number of computed terms is also significantly reduced. Compared to the RDTM, the nonlinear term in this method is replaced by related Adomian polynomials prior to the implementation of a multistep approach. As a consequence, only a smaller number of NLSE computed terms are required in the attained approximation. Moreover, the approximation also converges rapidly over a
... Show MoreThe effect of short range correlations on the inelastic longitudinal Coulomb form
factors for the lowest four excited 2+ states in 18O is analyzed. This effect (which
depends on the correlation parameter β) is inserted into the ground state charge
density distribution through the Jastrow type correlation function. The single particle
harmonic oscillator wave function is used with an oscillator size parameter b. The
parameters β and b are, considered as free parameters, adjusted for each excited state
separately so as to reproduce the experimental root mean square charge radius of
18O. The model space of 18O does not contribute to the transition charge density. As
a result, the inelastic Coulomb form factor of 18
The research aimed to prepare muscle elongation exercises for the arms with high intensity in which the training methods for young blind fencers vary, and to identify the effect of the diversity of muscle elongation exercises for the arms with high intensity on the cellular basal efficiency (lactic acid and sodium bicarbonate) and pulmonary respiration for young blind weapon fencers in terms of sports technology, and the experimental approach was adopted by designing the experimental and equal control groups, and the limits of the research community were represented by young fencers with shish weapon under the age of (20) years in the Army Sports Club, whose number is Total (15) swordsmen, continuing their training for the sports season (20
... Show MoreАрхив всех научных статей сборников конференций и журналов по направлению Филология.
In this work, we prove that the triple linear partial differential equations (PDEs) of elliptic type (TLEPDEs) with a given classical continuous boundary control vector (CCBCVr) has a unique "state" solution vector (SSV) by utilizing the Galerkin's method (GME). Also, we prove the existence of a classical continuous boundary optimal control vector (CCBOCVr) ruled by the TLEPDEs. We study the existence solution for the triple adjoint equations (TAJEs) related with the triple state equations (TSEs). The Fréchet derivative (FDe) for the objective function is derived. At the end we prove the necessary "conditions" theorem (NCTh) for optimality for the problem.
Irrigation scheduling techniques is one of the suggested solutions for water scarcity problem. The study aims to show the possibility of using practical and applicable irrigation scheduling program which was designed by Water Resources Department at the University of Baghdad by using Spreadsheet Formulas for Microsoft Excel program, version 2007, with some modification to generalize it and made it applicable to various climatic zone and different soil types, as a salvation for the shortage of irrigation water inside the irrigation projects. Irrigation projects which incidence of Tigris River basin will be taken as an applicable example. This program was based on water budgeting and programmed depending on scientific concepts which facili
... Show MorePurification of fifteen NaCl samples from natural and different area in the middle and south of Iraq are prepared and studied the structural characteristics of samples by powder X-ray diffraction analysis at ð›Œ=1.542Ã…. The present work considered the specific activities of naturally occurring radioactive materials in salt samples, which are measured and analyzed using high resolution HPGe system. Also, the radiological parameters have been considered in this work. The average specific concentration (in Bq.kg-1) of the salt samples is found 16.864.92 for 226Ra, 5.972.05 for 232Th and 9.852.8 for 40K, respectively, which are below the national levels, 40Bq.kg-1, 30Bq.k
... Show MoreToday the Genetic Algorithm (GA) tops all the standard algorithms in solving complex nonlinear equations based on the laws of nature. However, permute convergence is considered one of the most significant drawbacks of GA, which is known as increasing the number of iterations needed to achieve a global optimum. To address this shortcoming, this paper proposes a new GA based on chaotic systems. In GA processes, we use the logistic map and the Linear Feedback Shift Register (LFSR) to generate chaotic values to use instead of each step requiring random values. The Chaos Genetic Algorithm (CGA) avoids local convergence more frequently than the traditional GA due to its diversity. The concept is using chaotic sequences with LFSR to gene
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