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.
We 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
... Show MoreThe utilization of artificial intelligence techniques has garnered significant interest in recent research due to their pivotal role in enhancing the quality of educational offerings. This study investigated the impact of employing artificial intelligence techniques on improving the quality of educational services, as perceived by students enrolled in the College of Pharmacy at the University of Baghdad. The study sample comprised 379 male and female students. A descriptive-analytical approach was used, with a questionnaire as the primary tool for data collection. The findings indicated that the application of artificial intelligence methods was highly effective, and the educational services provided to students were of exceptional quality.
... Show MoreIn this paper we study the selection of cognitive elements and criteria of the inflectional structure of the Russian and Arabic languages in the process of speech communication. Phonetic-physiological principle is the main parameter by which the elements and criteria of cognitive activity in the presented study are distinguished. On the basis of the above mentioned parameter, we select the investigated criteria and elements. The first criterion is semantic, reflects the accordance of the elements of thinking to sound combinations in the studied languages, and allows us to distinguish the second criterion – morphonological. The second criterion depends on the phonetic changes of these combinations occurring in the process of speech activit
... Show MoreLet R be a commutative ring with unity and an R-submodule N is called semimaximal if and only if
the sufficient conditions of F-submodules to be semimaximal .Also the concepts of (simple , semisimple) F- submodules and quotient F- modules are introduced and given some properties .
Training has an effect on employees’ performances. Accordingly, the person who is responsible for employees’ development must figure out the most effective way to train and develop employees. Central Michigan University (CMU) has recognized the importance of providing appropriate training for employees who have a duty in advising students. The reason is that these employees have a significant impact on students’ educational performances. Thus, special attention to this category of employees is needed to improve advising quality. This research attempted to explore the impact of training on academic advising at CMU. Face-to-face interviews and online surveys were used as data collection tools for this study. The study scope c
... Show MoreThe article considers semantic and stylistic motivations for using obsolete lexicon (historicisms) in the text of a work of art. The specifics of the functioning of this process are presented against the background of the features of the contemporary Russian literary language. Attention is focused on the fact that the layer of obsolete lexical units belongs to a number of nationally specific vocabulary, the development of which forms an understanding of the nature of the actualized language. In addition, it should be noted that the semantics of historicisms is culturally commensurate: the latter is explained by the fact that the deactuation of linguistic units is positioned as parallel to the sociocultural and political changes.
... Show MoreThe ground state densities of unstable proton-rich 9C, 12N and 23Al exotic nuclei are studied via the framework of the two-frequency shell model (TFSM) and the binary cluster model (BCM). In TFSM, the single particle harmonic oscillator wave functions are used with two different oscillator size parameters βc and βv, where the former is for the core (inner) orbits and the latter is for the valence (halo) orbits. In BCM, the internal densities of the clusters are described by single particle Gaussian wave functions. The long tail performance is clearly noticed in the calculated proton and matter density distributions of these nuclei. The structure of the valence proton in 9C and 12N is a pure (1p1/2) configuration while that for 23Al is
... Show MoreThe electric quadrupole moments for some nitrogen isotopes (12,14,15,16,18N) are
studied by shell model calculations with the proton-neutron formalism. Theoretical
calculations performed using the different set of effective charges due to the core
polarization effect. The effective charges in the p-shell nuclei are found to be
slightly different from those in the sd-shell nuclei. Most of the results we have
obtained are underestimated with the measured data for the isotopes considered in
this work.
The intensification of competition among all companies and at different levels has become necessary for every company need to continue to improve its performance in order to be able to face the competition and stay in the market. To achieve this, we must rely on the company's accounting information more accurate and appropriate and provided in a timely manner, for the purpose of use in planning and decision making.
So there must be information systems that help the administration to continuous development and improvement of the performance of companies in general, and this is what you need Jordanian companies, especially after the accession of Jordan to the field
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