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, an algorithm for binary codebook design has been used in vector quantization technique, which is used to improve the acceptability of the absolute moment block truncation coding (AMBTC) method. Vector quantization (VQ) method is used to compress the bitmap (the output proposed from the first method (AMBTC)). In this paper, the binary codebook can be engender for many images depending on randomly chosen to the code vectors from a set of binary images vectors, and this codebook is then used to compress all bitmaps of these images. The chosen of the bitmap of image in order to compress it by using this codebook based on the criterion of the average bitmap replacement error (ABPRE). This paper is suitable to reduce bit rates
... Show MoreThere are many methods of searching large amount of data to find one particular piece of information. Such as find name of person in record of mobile. Certain methods of organizing data make the search process more efficient the objective of these methods is to find the element with least cost (least time). Binary search algorithm is faster than sequential and other commonly used search algorithms. This research develops binary search algorithm by using new structure called Triple, structure in this structure data are represented as triple. It consists of three locations (1-Top, 2-Left, and 3-Right) Binary search algorithm divide the search interval in half, this process makes the maximum number of comparisons (Average case com
... Show MoreThe current environment is witnessing several developments as a result of the changes taking place in all areas of economic, social , political and legal that led to the transformation of the industrial economy , which depends based on quantitative production to a knowledge economy which relies based on information and knowledge , as the central pillar of this economy during the trading of these information and knowledge between all individuals in general and decision makers , in particular, through information and communication technology of computers and the Internet to achieve sustainable human development in the social dimension. &
... Show MoreThe objective of this work is to study the concept of a fuzzy -cone metric space And some related definitions in space. Also, we discuss some new results of fixed point theorems. Finally, we apply the theory of fixed point achieved in the research on an integral type.
We presented in this paper a new class containing analytic univalent functions defined on unit disk. We obtained many geometric properties , like , coefficient inequality , distortion and growth theorems, convolution property, convex set, arithmetic mean and radius of starlikness and convexity by using Gaussian hypergeometric function for the class
The study seeks to identify e-governance requirements in human resources management, which are (administrative requirements, technical, human, financial, and security) which is a new style differs from the traditional management pattern, where work depends on multiple forms and methods of Tools, (e. g. computers and various electronic software), by relying on powerful information systems that help to make management decisions as quickly and less effortless and less expensive to keep up with the tremendous technological advancements in the field of information and communication technology revolution.
The sample included 132 Person who constitute a position (Director General, assistant Director General, section managers and d
... Show More"The aim of the research is to identify the availability of the dimensions of the research variables represented by organizational symmetry and the quality of work-life at the University of Information and Communications Technology, which is one of the formations of the Ministry of Higher Education and Scientific Research in Baghdad, in addition to knowing the relationship and influence between them. The research relied on the descriptive analytical approach based on peer description. The research was analyzed and the research sample consisted of (148) individuals, the sample was chosen using the comprehensive inventory method, data was obtained by relying on the questionnaire which was prepared from ready-made m
... Show MoreIn this study, we propose a suitable solution for a non-linear system of ordinary differential equations (ODE) of the first order with the initial value problems (IVP) that contains multi variables and multi-parameters with missing real data. To solve the mentioned system, a new modified numerical simulation method is created for the first time which is called Mean Latin Hypercube Runge-Kutta (MLHRK). This method can be obtained by combining the Runge-Kutta (RK) method with the statistical simulation procedure which is the Latin Hypercube Sampling (LHS) method. The present work is applied to the influenza epidemic model in Australia in 1919 for a previous study. The comparison between the numerical and numerical simulation res
... Show MoreBackground: As photochemical reaction that can stiffen the cornea, CXL is the only promising method of preventing progression of keratectasia such as KC and secondary ectasia following refractive surgery. The aim of CXL is to stabilize the underlying condition with a small chance of visual improvement. Objective: To show the sequences of changes in visual acuity and topographic outcomes during 1 year post CXL for patients with progressive Keratoconus.Type of the study: Cross sectional studyMethods: CXL procedure was done for 45 eyes with progressive KC. The following parameters had been monitored pre operatively, 1, 3, 6 and 12 months postoperatively: K apex, K2, corneal thickness at thinnest location, anterior and posterior elevation po
... Show MoreWe introduce in this paper the concept of approximaitly semi-prime submodules of unitary left -module over a commutative ring with identity as a generalization of a prime submodules and semi-prime submodules, also generalization of quasi-prime submodules and approximaitly prime submodules. Various basic properties of an approximaitly semi-prime submodules are discussed, where a proper submodule of an -module is called an approximaitly semi-prime submodule of , if whenever , where , and , implies that . Furthermore the behaviors of approximaitly semi-prime submodule in some classes of modules are studied. On the other hand several characterizations of this concept are
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