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 article considers the main reason for A. I. Herzen's address to obsolete words, which is their ability to acquire a stylistic coloring in the context of speech, as well as the possibility of combining, in some cases, with neutral lexemes of various functional styles. A certain stylistic effect of such characteristics of this type of vocabulary is represented, as a result of which their stylistic coloring in syntagmatic terms does not coincide with stylistic coloring in terms of paradigmatics, that is, in speech they have a completely stylistic meaning. Attention is focused on the role of outdated vocabulary, which consists in the fact that they serve to implement such features of the artistic style as imagery, emotionality, and their
... Show MoreStructure type and disorder have become important questions in catalyst design, with the most active catalysts often noted to be “disordered” or “amorphous” in nature. To quantify the effects of disorder and structure type systematically, a test set of manganese(III,IV) oxides was developed and their reactivity as oxidants and catalysts tested against three substrates: methylene blue, hydrogen peroxide, and water. We find that disorder destabilizes the materialsthermodynamically, making them stronger chemical oxidantsbut not necessarily better catalysts. For the disproportionation of H2O2 and the oxidative decomposition of methylene blue, MnOx-mediated direct oxidation competes with catalytically mediated oxidation, making the most
... Show MoreAbstract
This study identified the developing of a range of students' geography learning skills and the change in their attitudes toward fieldwork as a consequence of leaning experiences that occurred within a field trip. The sample of the study consisted of (27) students within a special topic course enrolled in Geography Department at Umm Al-Qura University in Saudi Arabia in semester 2, 2018. A range of students' geography learning skills were measured by the skills questionnaire that consisted of 12 geography skills after completing field work. Changes in students' at
... Show MoreThis study proposes a mathematical approach and numerical experiment for a simple solution of cardiac blood flow to the heart's blood vessels. A mathematical model of human blood flow through arterial branches was studied and calculated using the Navier-Stokes partial differential equation with finite element analysis (FEA) approach. Furthermore, FEA is applied to the steady flow of two-dimensional viscous liquids through different geometries. The validity of the computational method is determined by comparing numerical experiments with the results of the analysis of different functions. Numerical analysis showed that the highest blood flow velocity of 1.22 cm/s occurred in the center of the vessel which tends to be laminar and is influe
... Show MoreProblem: Cancer is regarded as one of the world's deadliest diseases. Machine learning and its new branch (deep learning) algorithms can facilitate the way of dealing with cancer, especially in the field of cancer prevention and detection. Traditional ways of analyzing cancer data have their limits, and cancer data is growing quickly. This makes it possible for deep learning to move forward with its powerful abilities to analyze and process cancer data. Aims: In the current study, a deep-learning medical support system for the prediction of lung cancer is presented. Methods: The study uses three different deep learning models (EfficientNetB3, ResNet50 and ResNet101) with the transfer learning concept. The three models are trained using a
... Show Moreorder to increase the level of security, as this system encrypts the secret image before sending it through the internet to the recipient (by the Blowfish method). As The Blowfish method is known for its efficient security; nevertheless, the encrypting time is long. In this research we try to apply the smoothing filter on the secret image which decreases its size and consequently the encrypting and decrypting time are decreased. The secret image is hidden after encrypting it into another image called the cover image, by the use of one of these two methods" Two-LSB" or" Hiding most bits in blue pixels". Eventually we compare the results of the two methods to determine which one is better to be used according to the PSNR measurs
Marriage outside the court is a manifestation of the oppression that women are subjected to in Iraq its seriousness comes out of the consequences that it leads to The. It overlooks the age of the girl and her marriage in younger age or coerced to marry as it leads to neglecting the affordability of marital relationship as long as the marriage does not have any legal or material consequences. The present study aims to detect Characteristics of both wives, husbands and families Who agree to marry her daughters outside the court. And the reasons that lead them to marry outside the courts. It also aims to provide information on the circumstances of marriage and reasons for refusing to ratify it in court. The study was based on the sample soc
... Show MoreLiterary translation is one of the most difficult types of translation ,because it conveys feelings that differ from one person to another, and since the language constitutes an obstacle to understanding the Andalusian excerpts, the translators resorted to translating it, and this was a second start to the text, different from its first start, is said from the tongue of the Al-washah , The muwashshah is a poetic art that appeared in Andalusia after the Arabs entered it ,characterized by special system It differs from the traditional Arabic poem, as it has a beginning represented in the beginning of the muwashshah and several equal parts ending with differentrhymes.
... Show MoreThe resort to the eloquence of the poetic image as a style reveals the poet's creativity and creativity in dealing with external influences, and reflect them with emotional images express a sense of intense emotional imagination, and this imagination stems from the experience of a poetic sense of truth, tasted by the recipient before the creator of the poetic text.
The aim of this research to show the role of some enzymes in pathological mechanism of rheumatoid arthritis (RA) disease. Sixty patients with RA and matched number of apparently healthy volunteers were included in the study. Spectrophotometric methods were used to determine Peroxy nitrite (ONOO), Nitric oxide (NO), Nitric oxide synthase activity (NOS) cycloxygenase-2 activity (COX-2), glutathione peroxidase (GPX) activity and superoxide dismutase (SOD) activity in serum of both groups. Colorimetric assay kits were used to determine Iron. Rheumatoid factor (RF) was determined using Imuno-Latex kit. ONOO, NO levels, and NOS activity were significantly higher in the patients compared to the control group. Conversely, Iron level, SOD
... Show More