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.
In this paper, some conditions to guarantee the existence of bounded solution to the second order multi delayed arguments differential equation are given. The Krasnoselskii theorem used to the Lebesgue’s dominated convergence and fixed point to obtain some new sufficient conditions for existence of solutions. Some important lemmas are established that are useful to prove the main results for oscillatory property. We also submitted some sufficient conditions to ensure the oscillation criteria of bounded solutions to the same equation.
Desulfurization of a simulated diesel fuel by different adsorbents was studied in a fixed-bed adsorption process operated at ambient temperature and pressure. Three different adsorption beds were used, commercial activated carbon, Cu-Y zeolite, and layered bed of 15wt% activated carbon followed by Cu-Y zeolite.Initially Y-zeolite was prepared from Iraqi rice husk and then impregnated with copper. In general, the adsorbents tested for total sulfur adsorption capacity at break through followed the order Ac/Cu-Y zeolite>Cu-Y zeolite>Ac. The best adsorbent, Ac/Cu-Y zeolite is capable of producing more than 30 cm3 of simulated diesel fuel per gram of adsorbent with a weighted average content of 5 ppm-S, while Cu-Y zeolite producing of
... Show MoreThe aim of this study is to get practical evidence from the Egyptian business environment The Impact of Audit Committees Effectiveness and External Audit Quality on Timeliness of annual Financial Report. Design and methodology: The study based on the content analysis technique to examine the annual reports of a sample of (30) companies listed on the Egyptian Stock Exchange (EGX100) during the period (2016-2019) with a total of (120) respondents. To test the research hypotheses, the results of the study indicate that there is a negative significant impact of audit committees on timeliness of annual financial report. Moreover, while there is a negative impact on the quality of the external audit on the timing of issuing the annual
... Show MoreBackground: Phenylketonuria (PKU) is one of the most important metabolic causes for mental retardation in children, in which early diagnosis would successfully prevent mental retardation, yet, there are some other serious metabolic diseases that share the same mode of presentation and some of the phenotypic manifestations also.
Methods: During the period from August 2009 to August 2011, 63 cases were referred to the Children Welfare Teaching Hospital (CWTH) with clinical features of PKU, all were enrolled in this study, few blood drops on a special filter paper were taken from each patient and sent to a specialized metabolic laboratory in Saint Joseph University \Beirut, using tandem mass
Many studies have recommended implying the skills and strategies of creative thinking, critical thinking, and reflective thinking in EFLT curriculum to overcome EFL teaching-learning process difficulties. It is really necessary to make EFL teachers aware of the importance of cultural thinking and have a high perception of its forces. Culture of thinking consists of eight cultural forces in every learning situation; it helps to shape the group's cultural dynamic. These forces are expectations, language, time, modeling, opportunities, routines, interactions, and environment. This study aims to investigate EFL student-teachers’ perceptions of cultural thinking. The participants are selected randomly from the fourth-stage students at the D
... Show MoreOur aim in this paper is to introduce the notation of nearly primary-2-absorbing submodule as generalization of 2-absorbing submodule where a proper submodule of an -module is called nearly primary-2-absorbing submodule if whenever , for , , , implies that either or or . We got many basic, properties, examples and characterizations of this concept. Furthermore, characterizations of nearly primary-2-absorbing submodules in some classes of modules were inserted. Moreover, the behavior of nearly primary-2-absorbing submodule under -epimorphism was studied.
Abstract
This study aims to identify the reality of using electronic applications in teaching language skills to people with mild intellectual disabilities from the mothers’ perspective. A descriptive approach was used. The electronic questionnaires were administered to the study sample, 122 responses were received from mothers of the students with mild intellectual disability in Hafer Al-Baten schools. The response average rate was 94%. The results showed that there are statistically significant differences that are related to the variant of monthly income as for the barriers to using electronic applications in such schools, whereas there were no differences regarding the variant of monthly income regarding t
... Show MoreThis study aimed to reveal the extent to which the values of social peace are included in the content of social and national studies textbooks of the middle stage in kingdom of Saudi Arabia. To achieve this goal, the researcher used the descriptive analytical approach. The study sample consisted of all developed social and national studies textbooks of the middle stage in kingdom of Saudi Arabia in first and second semester of student books in edition of 1439-1440. The study tool was the analysis card. The study reached the following results: 1-The content of social and national studies textbooks of the middle stage in kingdom of Saudi Arabia as a whole included (38) social peace values of total (40) values, corresponding to the inclusio
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