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.
Political Discourse Analysis is an important linguistic study approach used by politicians to gain people support. The present paper sheds light on the figures of speech of emphasis in the televised debate between the two presidential elections candidates, Emmanuel Macron and Marine Le Pen and the distinctive effect they add to the political discourse to win general public support as well as the presidential elections.
The present paper provides a rudimentary definition and an analysis of the terms “discourse” and “political discourse” and traces the significant role played by politically directed televised Media and internet to support political pa
... Show MoreThe aim of this paper is to estimate a single reliability system (R = P, Z > W) with a strength Z subjected to a stress W in a stress-strength model that follows a power Rayleigh distribution. It proposes, generates and examines eight methods and techniques for estimating distribution parameters and reliability functions. These methods are the maximum likelihood estimation(MLE), the exact moment estimation (EMME), the percentile estimation (PE), the least-squares estimation (LSE), the weighted least squares estimation (WLSE) and three shrinkage estimation methods (sh1) (sh2) (sh3). We also use the mean square error (MSE) Bias and the mean absolute percentage error (MAPE) to compare the estimation methods. Both theoretical c
... Show MoreThis study ideals with the Omani legal regulations of transferring and transplanting human organs and tissues in light of the Minister of Health decree No. 179 on the year 2018. As the last update, article 27 in 2019 has prohibited conducting such operations unless permission from the Minister of Health is obtained. In the absence of a further law update until the completion of writing the research, we intend to analyze and study some of the current provisions for the transfer and transplantation of human organs and tissues, compared to the legislative trends of some related laws. To achieve this, we divided the study into three sections; the first section introduces the historical development of the legislator criminal policy in regulat
... Show MoreThis research includes the use of an artificial intelligence algorithm, which is one of the algorithms of biological systems which is the algorithm of genetic regulatory networks (GRNs), which is a dynamic system for a group of variables representing space within time. To construct this biological system, we use (ODEs) and to analyze the stationarity of the model we use Euler's method. And through the factors that affect the process of gene expression in terms of inhibition and activation of the transcription process on DNA, we will use TF transcription factors. The current research aims to use the latest methods of the artificial intelligence algorithm. To apply Gene Regulation Networks (GRNs), we used a progr
... Show MoreLet G be a graph, each edge e of which is given a weight w(e). The shortest path problem is a path of minimum weight connecting two specified vertices a and b, and from it we have a pre-topology. Furthermore, we study the restriction and separators in pre-topology generated by the shortest path problems. Finally, we study the rate of liaison in pre-topology between two subgraphs. It is formally shown that the new distance measure is a metric
Soft closure spaces are a new structure that was introduced very recently. These new spaces are based on the notion of soft closure operators. This work aims to provide applications of soft closure operators. We introduce the concept of soft continuous mappings and soft closed (resp. open) mappings, support them with examples, and investigate some of their properties.
تهدف هذه الدراسة للتعرف على السياسات اإلاسرائيلية المتبعة على الارض والمتمثلة في االاستيطان
الاستعماري والطرق التفافية، ومصادرة الاراضي وجدار الضم والتوسع العنصري، بالاضافة إلى التصنيف
الاداري للمناطق في الضفة الغربية حسب ما جاء في اتفاقية أوسلو، والتي من شأنها التأثير على تلك
المناطق، وال سيما قطاع اإلسكان الذي يعد من أهم القطاعات التي تتر كب وبالتحديد في منطقة الدراسة،
وسوف تحاول هذه الدراسة تس
Let R be a commutative ring with identity and E be a unitary left R – module .We introduce and study the concept Weak Pseudo – 2 – Absorbing submodules as generalization of weakle – 2 – Absorbing submodules , where a proper submodule A of an R – module E is called Weak Pseudo – 2 – Absorbing if 0 ≠rsx A for r, s R , x E , implies that rx A + soc ( E ) or sx A + soc (E) or rs [ A + soc ( E ) E ]. Many basic properties, char
... Show MoreIn this paper, we introduce new definitions of the - spaces namely the - spaces Here, and are natural numbers that are not necessarily equal, such that . The space refers to the n-dimensional Euclidean space, refers to the quaternions set and refers to the N-dimensional quaternionic space. Furthermore, we establish and prove some properties of their elements. These elements are quaternion-valued N-vector functions defined on , and the spaces have never been introduced in this way before.
Despite the significant increase in public spending in Iraq, it was not directed toward the important sectors that have an important role in correcting the productive structure. Rather, most of the public expenditure was going to cover the required imports, or to face shocks, whether security or health, and this caused a continuous decrease in the volume of Iraq's exports of goods and services, as the aim of the study was to review the importance of public debt and its impact on the trade balance, as well as to know the economic policies that can contribute to strengthening the trade balance, as the study proved through the (ARDL) model that there is a direct relationship between the domestic debt and the net trade balance, and an invers
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