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.
Most recognition system of human facial emotions are assessed solely on accuracy, even if other performance criteria are also thought to be important in the evaluation process such as sensitivity, precision, F-measure, and G-mean. Moreover, the most common problem that must be resolved in face emotion recognition systems is the feature extraction methods, which is comparable to traditional manual feature extraction methods. This traditional method is not able to extract features efficiently. In other words, there are redundant amount of features which are considered not significant, which affect the classification performance. In this work, a new system to recognize human facial emotions from images is proposed. The HOG (Histograms of Or
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It considers training programs is an important process contributing to provide employees with the skills required to do their jobs efficiently and effectively, so it should be concerned with and the focus of all government our organizations, and perhaps the most important reasons that I was invited to select the subject (evaluation of training programs directed toward the diagnosis of the phenomenon of financial and administrative corruption) It is the importance of those programs working in the regulatory institutions General and the Office of Inspector General of Finance and the Ministry particularly for employees because of their role in the development of their skills and their experience and their beha
... Show MoreThe importance of research and study of classical Persian literature is not overlooked. So far, there have been many studies in this area. But there are still some things that need more research. Persian grammar is one of the most important branches of Persian literature. This section has always been converted at different times. One of the issues that has been neglected in the studies of classical literature is the study of the technical tales of past and past poetry. These texts can be studied from different perspectives. Because Persian is a mixed language, it is possible to combine language terms with each other or to add prefixes and suffixes to express new concepts. They can be used by exam
... 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 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
... Show MoreRate of penetration plays a vital role in field development process because the drilling operation is expensive and include the cost of equipment and materials used during the penetration of rock and efforts of the crew in order to complete the well without major problems. It’s important to finish the well as soon as possible to reduce the expenditures. So, knowing the rate of penetration in the area that is going to be drilled will help in speculation of the cost and that will lead to optimize drilling outgoings. In this research, an intelligent model was built using artificial intelligence to achieve this goal. The model was built using adaptive neuro fuzzy inference system to predict the rate of penetration in
... Show MoreIn this research, an unknown space-dependent force function in the wave equation is studied. This is a natural continuation of [1] and chapter 2 of [2] and [3], where the finite difference method (FDM)/boundary element method (BEM), with the separation of variables method, were considered. Additional data are given by the one end displacement measurement. Moreover, it is a continuation of [3], with exchanging the boundary condition, where are extra data, by the initial condition. This is an ill-posed inverse force problem for linear hyperbolic equation. Therefore, in order to stabilize the solution, a zeroth-order Tikhonov regularization method is provided. To assess the accuracy, the minimum error between
... Show MoreThis research display a selected sample of Regelson's texts, there were interrelations and interactions unfolded so as to show his creativity in the employment of religious texts. In the story "In the Youth of Moses", he inter-texted the episode of the Prophet Moses from the Torah, the Source of legislation, to signify a legislative issue needed by the community. As for the story of "Samson, One of the Falling", he originated the character of The Judge Samson by alluding to the Book of the Judges, which is the Book which reminded of the defeat and slavery of the Palestinians by a Jewish leader, as is related in Jewish religious texts. Further, and the story of "And Haman Said", he chose the story of the Queen Esther from the Book of Esth
... Show MoreGangyong Lee, S.Tariq Rizvi, and Cosmin S.Roman studied Rickart modules.
The main purpose of this paper is to develop the properties of Rickart modules .
We prove that each injective and prime module is a Rickart module. And we give characterizations of some kind of rings in term of Rickart modules.
תקציר
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
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