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 many scientific fields, Bayesian models are commonly used in recent research. This research presents a new Bayesian model for estimating parameters and forecasting using the Gibbs sampler algorithm. Posterior distributions are generated using the inverse gamma distribution and the multivariate normal distribution as prior distributions. The new method was used to investigate and summaries Bayesian statistics' posterior distribution. The theory and derivation of the posterior distribution are explained in detail in this paper. The proposed approach is applied to three simulation datasets of 100, 300, and 500 sample sizes. Also, the procedure was extended to the real dataset called the rock intensity dataset. The actual dataset is collecte
... Show MoreCollaborative learning is a way that prepares students practically for real-world applications. Working together as teamwork to execute various writing skills is essential in most professions since it increases the level of experience. Thus, the current study aims to identify the role collaborative writing in developing students' level of performance in writing. It is qualitative in nature since the researcher depended on the extant literature in achieving the objective of the study. The researcher touched upon related theories that addressed Collaborative learning, categories, and problems .It concluded that collaborative writing increases the students’ self-confidence, self-esteem, creativity, and motivation through the interact
... Show MoreIn this paper, a modified derivation has been introduced to analyze the construction of C-space. The profit from using C-space is to make the process of path planning more safety and easer. After getting the C-space construction and map for two-link planar robot arm, which include all the possible situations of collision between robot parts and obstacle(s), the A* algorithm, which is usually used to find a heuristic path on Cartesian W-space, has been used to find a heuristic path on C-space map. Several modifications are needed to apply the methodology for a manipulator with degrees of freedom more than two. The results of C-space map, which are derived by the modified analysis, prove the accuracy of the overall C-space mapping and cons
... Show MoreOne’s character is shaped by the family he/she has and the way he/she is raised up. Bad parents affect their children tragically, and the later consequences, the parents are the ones who pay for being bad ones. Tracy Letts explores the dark side of family life in his domestic play August: Osage County (2007), one of the most well-known contemporary plays of American theatre in the twenty-first century. The playwright presents the Westons as an embodiment of the image of family disconnected relationships due to bad parenting. Violet is a model of a bad mother who plays a prominent role in destroying her family. The impact of bad parenting is revealed in the circle of the formerly abused children who turned to be abusers of their children o
... Show MoreThe right to property is one of the most fundamental rights enjoyed by individuals, and most national constitutions and laws, as well as international conventions, have to be respected and protected only in accordance with the economic and social development of the country (the so-called public benefit) and in return for just compensation. What is fair compensation?
Psychosocial Alienation is a modern concept that arises from the capitalist and materialistic conceptions of individuals. The evergrowing competitive nature of domestic societies crystallised the concept in its modern form. The intensity of the rapid changes in the urbanised societies prevents the individuals from exploring their inner selves. Thus, a new generation is created with an alienation crisis which is reflected inward towards the self and outwards toward society. Alan Ayckbourn (1939), A British playwright, presents Alienated characters inspired by his life on and off stage. He explores their Alienation and their path toward recovery and self-realization. A Brief History of Women (2017) Ayckbourn explores the depth of the individu
... Show MoreThe researchers of the present study have conducted a genre analysis of two political debates between American presidential nominees in the 2016 and 2020 elections. The current study seeks to analyze the cognitive construction of political debates to evaluate the typical moves and strategies politicians use to express their communicative intentions and to reveal the language manifestations of those moves and strategies. To achieve the study’s aims, the researchers adopt Bhatia’s (1993) framework of cognitive construction supported by van Emeren’s (2010) pragma-dialectic framework. The study demonstrates that both presidents adhere to this genre structuring to further their political agendas. For a positive and promising image
... Show MoreBee keping projects is one of the most important agricltural investment projects because it generate profit in a short period . In addition to the multiplicity of products and other benefits . Research aimed at study the feasibility of two projects one hand in the origin of the Al – Mashrok since 2006 , kicking off with ten hives , and the scond proposal , kicking of 100 hives using the criteria of the world bank . Results showed that the bee keeping projects is economically feasible, whether small or large .. Even when the analysis of the sensitivity of the project to changes which may occur in the price of output and resources by reducing costs and increasing revenues by 10% it remains economically viable .
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