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.
Throughout this paper R represents a commutative ring with identity and all R-modules M are unitary left R-modules. In this work we introduce the notion of S-maximal submodules as a generalization of the class of maximal submodules, where a proper submodule N of an R-module M is called S-maximal, if whenever W is a semi essential submodule of M with N ? W ? M, implies that W = M. Various properties of an S-maximal submodule are considered, and we investigate some relationships between S-maximal submodules and some others related concepts such as almost maximal submodules and semimaximal submodules. Also, we study the behavior of S-maximal submodules in the class of multiplication modules. Farther more we give S-Jacobson radical of ri
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Throughout this paper R represents a commutative ring with identity and all R-modules M are unitary left R-modules. In this work we introduce the notion of S-maximal submodules as a generalization of the class of maximal submodules, where a proper submodule N of an R-module M is called S-maximal, if whenever W is a semi essential submodule of M with N ⊊ W ⊆ M, implies that W = M. Various properties of an S-maximal submodule are considered, and we investigate some relationships between S-maximal submodules and some others related concepts such as almost maximal submodules and semimaximal submodules. Also, we study the behavior of S-maximal submodules in the class of multiplication modules. Farther more we give S-Jacobson radical of rings
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The study aims to integrate the visually impaired people into the art connoisseur community through producing special print artworks to enable the visually impaired people to use their other senses to feel artworks by using artistic printing techniques through adding some prominent materials to the printing colors or making an impact that visually impaired people can perceive using their other senses. This study also aims to set up art exhibitions that display tangible works that can enable visually impaired people to feel artwork and understand its elements to enable them to feel it through other senses.
The study follows the experimental method, through using artistic printing techniques, which allow printing with prominent textur
Аннотация
в статье рассматриваются проблемы преподавания русской литературы в иракской аудитории.. Использование литературы в преподавании иностранного языка, как правило, имеет две цели. Первая-чисто лингвистическая .. Вторая цель, однако, ассоциируется больше с экстралингвистикой и представляет собой ознакомление студентов с различными аспектами русской жизни, культуры,
... Show MoreThe nucleon momentum distributions (NMD) and elastic electron scattering form factors of the ground state for some 1f-2p-shell nuclei, such as 58Ni, 60Ni, 62Ni, and 64Ni
isotopes have been calculated in the framework of the coherent fluctuation model (CFM) and expressed in terms of the weight function lf(x)l2 . The weight function (fluctuation function) has been related to the nucleon density distribution (NDD) of the nuclei and determined from the theory and experiment. The NDD is derived from a simple method based on the use of the single particle wave functions of the harmonic oscillator potential and the occupation numbers of the states. The feature of the l
Rock engineers widely use the uniaxial compressive strength (UCS) of rocks in designing
surface and underground structures. The procedure for measuring this rock strength has been
standardized by both the International Society for Rock Mechanics (ISRM) and American Society
for Testing and Materials (ASTM), Akram and Bakar(2007).
In this paper, an experimental study was performed to correlate of Point Load Index ( Is(50))
and Pulse Wave Velocity (Vp) to the Unconfined Compressive Strength (UCS) of Rocks. The effect
of several parameters was studied. Point load test, Unconfined Compressive Strength (UCS) and
Pulse Wave Velocity (Vp) were used for testing several rock samples with different diameters.
The predicted e
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The estimation of the parameters of linear regression is based on the usual Least Square method, as this method is based on the estimation of several basic assumptions. Therefore, the accuracy of estimating the parameters of the model depends on the validity of these hypotheses. The most successful technique was the robust estimation method which is minimizing maximum likelihood estimator (MM-estimator) that proved its efficiency in this purpose. However, the use of the model becomes unrealistic and one of these assumptions is the uniformity of the variance and the normal distribution of the error. These assumptions are not achievable in the case of studying a specific problem that may include complex data of more than one model. To
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In this paper mildly-regular topological space was introduced via the concept of mildly g-open sets. Many properties of mildly - regular space are investigated and the interactions between mildly-regular space and certain types of topological spaces are considered. Also the concept of strong mildly-regular space was introduced and a main theorem on this space was proved.
The paper is devoted to solve nth order linear delay integro-differential equations of convolution type (DIDE's-CT) using collocation method with the aid of B-spline functions. A new algorithm with the aid of Matlab language is derived to treat numerically three types (retarded, neutral and mixed) of nth order linear DIDE's-CT using B-spline functions and Weddle rule for calculating the required integrals for these equations. Comparison between approximated and exact results has been given in test examples with suitable graphing for every example for solving three types of linear DIDE's-CT of different orders for conciliated the accuracy of the results of the proposed method.
A confluence of forces has brought journalism and journalism education to a precipice. The rise of fascism, the advance of digital technology, and the erosion of the economic foundation of news media are disrupting journalism and mass communication (JMC) around the world. Combined with the increasingly globalized nature of journalism and media, these forces are posing extraordinary challenges to and opportunities for journalism and media education. This essay outlines 10 core principles to guide and reinvigorate international JMC education. We offer a concluding principle for JMC education as a foundation for the general education of college students.