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.
There is no doubt that the achievement of the manuscripts of There is no doubt various of situations for performing a duty , The diversity of stimuli in humans with sensory, unconscious and instinct sensitive systems. Which leads to a diversity of feelings, sensations, emotions and feelings, This therefore requires different types of function linguistic structures indication , Of that linguistic potential that God willing to be unique, In the function of discharging and venting those feelings and emotions that are raised by its various stimuli, which are only needs and psychological and biological purposes require verification and access and gain it. S
... Show MoreThe Research Aims To Clarify The Role Of Knowledge Innovation On The Administrative Process Represented by Managing Strategic Momentum, The Research Problem Focuses on Administrative leader Interest In And Implementation Of The Innovation Element Of Knowledge In The Organization By " Managing Strategic Momentum" As Well As The Focus By Management About The Innovators And Makers Of Knowledge And Strategic Planners In The Design And Formulation Of Strategic. Research does Contribute In Solving Part Of The Organizational Problems Of Vision, Innovation And Their Impact On The Momentum Management To Determine The Extent On Which The Procedures Of The Assessed Companies And Plan To Regulate Innovation Under The Momentu
... Show MorePurpose: The purpose of this study was to clarify the basic dimensions, which seeks to indestructible scenarios practices within the organization, as a final result from the use of this philosophy.
Methodology: The methodology that focuses adoption researchers to study survey of major literature that dealt with this subject in order to provide a conceptual theoretical conception of scenarios theory .
The most prominent findings: The only successful formulation of scenarios, when you reach the decision-maker's mind wa takes aim to form a correct mental models, which appear in the expansion of Perception managers, and adopted as the basis of the decisions taken. The strength l
... Show MoreThis paper tackles tragedy and grief in the Hebrew poetry of the Middle Ages, as being topics which was transferred to it from Arabic poetry at that time. This came as a result of Hebrew poets quoting images from, and adopting the form and content of the Arabic poem. So, this topic was a prominent feature in the Hebrew poetry of the middle ages. The Hebrew poets focused upon this topic along three trends: poems of lamentation, whether being what are called national lamentation where poets expressed their feelings and grieves because of their remoteness and longing to their homeland, which is Palestine or the sacred land, as they claim; here, Zionist trends were apparent in many poems lamenting Zion and other cities. The other type of poe
... Show MoreThe current study seeks to evaluate teacher preparation programs in the scientific disciplines at the College of Education in Al-Aqsa University in the light of the requirements of the labor market. It further aims to reveal the significance of the differences in the sample members’ response averages of to the availability of labor market requirements in the program that prepares the teacher of scientific disciplines at the Faculty of Education in Al-Aqsa University taking into account the (gender, program) variables. The study followed the descriptive analytical approach, and so a questionnaire was distributed to a sample of scientific discipline students in the teacher preparation program adopted in Al-Aqsa University, (200) male and
... Show MoreIn this paper, a new technique is offered for solving three types of linear integral equations of the 2nd kind including Volterra-Fredholm integral equations (LVFIE) (as a general case), Volterra integral equations (LVIE) and Fredholm integral equations (LFIE) (as special cases). The new technique depends on approximating the solution to a polynomial of degree and therefore reducing the problem to a linear programming problem(LPP), which will be solved to find the approximate solution of LVFIE. Moreover, quadrature methods including trapezoidal rule (TR), Simpson 1/3 rule (SR), Boole rule (BR), and Romberg integration formula (RI) are used to approximate the integrals that exist in LVFIE. Also, a comparison between those
... Show MoreA progressive increase in the desire for environmentally friendly lubricants by users and strict government regulations for the use of these lubricants has provided an opportunity to use plant oils as biodegradable lubricants, therefore vegetable oils have been investigated to replace oil lubricants because of their maintaining the conditions of nature (environment) properties. In this paper, the influences of the blending ratio of mustard seeds oil with commercial mineral oil (SAE40) on the tribological characteristics were investigated and compared with mineral oil using the four-ball tribotester. Mustard seeds oil was blended with mineral oil at a volumetric ratio ranging from 22.5 to 90%. All experimental works were
... Show MoreShmuel Yosef Agnon, a well-known Jewish writer, wrote many literary works, including poetry, story, etc. In the field of story, this writer used two areas: the first: a simple exterior, and the second: an inner full of secrets and mysteries. This area is common when Agnon is affected by his symbolic method of purpose. In his productions, we find the political and historical significance embodied in his characters, where there is almost no story without it.
Agnon and all his productions gave the character a large area, Agnon’s characters often play the center and cornerstone in those productions, where the author dealt deeply and stated the fines details of the external and internal of that ch
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ביטויי אהבה ושנאה קבלה בההגדרות שונות, לפעמים ביניהם לבין עצמם והסכימו בזמנים אחרים מהבחינה הדתית נתפסה לאהוב ביטויים ושנאה במונחים של טוב ורע, או במונחים של חלאל וחראם למעשה, הרגשות של אהבה ושנאה הם רגשות אנושיים המקושרים לאמונות של חברות אנושיות הבנויות על העמדה של דתות מכל נושא או מקרה , דבר אשר אהוב על ידי הקדושים והכמורה יהיה חלאל, וכל מה שהם שונאים יהיה חראם במילים אח
... Show MoreThe deployment of UAVs is one of the key challenges in UAV-based communications while using UAVs for IoT applications. In this article, a new scheme for energy efficient data collection with a deadline time for the Internet of things (IoT) using the Unmanned Aerial Vehicles (UAV) is presented. We provided a new data collection method, which was set to collect IoT node data by providing an efficient deployment and mobility of multiple UAV, used to collect data from ground internet of things devices in a given deadline time. In the proposed method, data collection was done with minimum energy consumption of IoTs as well as UAVs. In order to find an optimal solution to this problem, we will first provide a mixed integer linear programming m
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