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 intensification of competition among all companies and at different levels has become necessary for every company need to continue to improve its performance in order to be able to face the competition and stay in the market. To achieve this, we must rely on the company's accounting information more accurate and appropriate and provided in a timely manner, for the purpose of use in planning and decision making.
So there must be information systems that help the administration to continuous development and improvement of the performance of companies in general, and this is what you need Jordanian companies, especially after the accession of Jordan to the field
... Show MoreThe article considers semantic and stylistic motivations for using obsolete lexicon (historicisms) in the text of a work of art. The specifics of the functioning of this process are presented against the background of the features of the contemporary Russian literary language. Attention is focused on the fact that the layer of obsolete lexical units belongs to a number of nationally specific vocabulary, the development of which forms an understanding of the nature of the actualized language. In addition, it should be noted that the semantics of historicisms is culturally commensurate: the latter is explained by the fact that the deactuation of linguistic units is positioned as parallel to the sociocultural and political changes.
... 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
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
The national educational systems both in the Russian Federation and Iraq Republic have to adjust the training programs to duly prepare the pedagogical university students for the modern challenges and situations on the market of educational services. For success of the service, the education specialists have to fully mobilize their physical, mental and emotional resources and persistently advance their skills and knowledge using the relevant online education courses; practical research conferences; persistent self-education to master theoretical fundamentals of the modern physical education and sport service; and be active in trainings and competitions in their vocational individual game sports including badminton, table tennis and tennis.
... Show MoreMixing this strategy with a qualitative research design and an idea known as AI-supported journalism, the paper is going to approach the requirements of how AI technologies may transform journalism content and culture in a way beyond what one anticipates; therefore, enabling more of it to reach an audience. The current research used descriptive research design to investigate the potential applications of the AI tools that mediate civilizational conversation and a structured questionnaire to media professionals. AI-driven journalism can promote peaceful cohabitation and mutual respect and thus act as a bridge between cultures, the research said. The piece even goes on to mention the need for media establishments and civil soc
... Show MoreThe purpose and goal of the research revolve around the diagnosis of intellectual capital as the logical indicator to study an effective human resource management practice and its influential role in determining the overall quality management of higher education institutions and scientific research in Baghdad.
To achieve the purpose of the research, an upgraded standard questionnaire was used to collect data and distribute it to the selected sample in a statistical manner from the study population of (5) institutions affiliated with the Ministry of Higher Education and Scientific Resear
... Show MoreDespite 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
... Show MoreBeing the meeting points of the world different languages and out of a scholarly perspective, comparative literature represents a cultural leap as well as an artistic and intellectual development or a global literary movement of both prose and poetry. Such homogenous literary structure requires a systematic and coherent study of the literary output of the people different cultures and civilizations. It also represents the theoretical approach of the present study that debates a systematic comparison between Ghassan Kanafani’s All That's Left to You and William Faulkner’s. The Sound and the Fury. Within the perspective of the descriptive analysis approach, the present paper discusses th
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