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.
The state did not witness the emergence of independent bodies because of the nature of the ruling regimes that were characterized by political tyranny represented by the king at the time, as is the case with Greece and the Greeks and Persia and the Romans and others. As for the Islamic state, which emerged later, it saw the emergence of what looks like independent bodies that we see today, There was the so-called Diwan Al-Hesba and the Ombudsman's Office as an independent body from the Islamic State, which operated independently to support the oppressed and the equitable distribution of financial resources, even though it was headed by well-known governors of justice and honesty. A state in the modern era, many countries, especially in E
... Show MoreDavid Hare (b.1947) is one of the most critically acclaimed, contemporary British dramatists. A playwright, director and filmmaker, he has written more than thirty plays for the stage and seven original screen plays for cinema and TV (Susan Emerling, p.1). He began his dramatic career in the late sixties. Along with such dramatists as Howard Brenton and Trevor Griffiths, he writes in the aftermath of the "Angry Young Men" tradition of John Osborne. It is a well-known fact that the element of anger continued in the drama of the 1960s and became even more radicalized after the social, cultural and political unrests of 1968 by the dramatists of the "second wave" to whom Hare belongs (John Russell Taylor, p.14). Setting his plays in a variet
... Show MoreAn excellent reputation earned by initiating and practicing sustainable business practices has additional benefits, of which are reducing environmental incidents and an improvement in operational efficiency as this has the potential to help firms improve on productivity and bring down operating costs. Taken further, with ever-increasing socially and environmentally-conscious investors and the public alike, this act of natural resources management could have a significant implication on market value and income of the practicing firms.
The above proposition has been supported by sustainable business practices literature that is continuously conversing and deliberating upon the impact of efficient resource d
... Show MoreImplementation of TSFS (Transposition, Substitution, Folding, and Shifting) algorithm as an encryption algorithm in database security had limitations in character set and the number of keys used. The proposed cryptosystem is based on making some enhancements on the phases of TSFS encryption algorithm by computing the determinant of the keys matrices which affects the implementation of the algorithm phases. These changes showed high security to the database against different types of security attacks by achieving both goals of confusion and diffusion.
the pursue of social systems history present to us solid evidence that the collapse of that systems be caused by either the stagnancy aftermath maturity or unreal intellectual foundation which lead to sudden collapse, while the capitalism can avoided that intellectual damages due to its dynamic system with appropriate auto adaptation mechanism and use it excellently in the right time.
The globalization had excrete (as one of the capitalism adaptation mechanism) its own targets and its methods in framework of multinationals corporations which consist with capitalism states that employed the international organizations to reconstruction the global economy to serve such targets. So the glob
... Show MoreThe Department of Chemical and Biological Engineering, Al-Khwarizmi College of Engineering at Baghdad University has lately renovated its own research laboratories to comply with international safety measures and conduct undergraduate and postgraduate research. In this regard, the department has harnessed some amenities within the college to establish these laboratories taking into accounts creating a convenient, safe, and developed working environment for both researchers and students. A precise procedure was followed to establish this laboratory which includes providing new bench tops which offer spacious working places for workers. These benches were supplied with power points, gas, water, and compressed air outlets. In addition,
... Show MoreThe notion of interval value fuzzy k-ideal of KU-semigroup was studied as a generalization of afuzzy k-ideal of KU-semigroup. Some results of this idea under homomorphism are discussed. Also, we presented some properties about the image (pre-image) for interval~ valued fuzzy~k-ideals of a KU-semigroup. Finally, the~ product of~ interval valued fuzzyk-ideals is established.
Globally, the COVID-19 pandemic’s development has presented significant societal and economic challenges. The carriers of COVID-19 transmission have also been identified as asymptomatic infected people. Yet, most epidemic models do not consider their impact when accounting for the disease’s indirect transmission. This study suggested and investigated a mathematical model replicating the spread of coronavirus disease among asymptomatic infected people. A study was conducted on every aspect of the system’s solution. The equilibrium points and the basic reproduction number were computed. The endemic equilibrium point and the disease-free equilibrium point had both undergone local stability analyses. A geometric technique was used
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