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 energy that a radiation source emits as light (photons), electromagnetic waves, or particles is known as radiation. X-ray is one type of ionizing radiation that falls within the electromagnetic wave category of short wavelengths. Because of their short wavelength. X-ray is a type of ionizing radiation that is used in a constantly growing number of diagnostic procedures. X-ray diagnostic imaging has been employed in the medical field for more than a century(Hariyoto et al., 2020). Radiation has advantages for human health, but there is also a risk. the impacts of Radiation on Fertility it is an oligospermia, or a reduction in the number of sperm cells, which is already possible after radiation exposure of 0.15 mGy. It Leads to impede
... Show MorePurpose: The purpose of this study was to clarify the basic dimensions, which seeks to indestructible scenarios practices within the organization, as a final result from the use of this philosophy.
Methodology: The methodology that focuses adoption researchers to study survey of major literature that dealt with this subject in order to provide a conceptual theoretical conception of scenarios theory .
The most prominent findings: The only successful formulation of scenarios, when you reach the decision-maker's mind wa takes aim to form a correct mental models, which appear in the expansion of Perception managers, and adopted as the basis of the decisions taken. The strength l
... Show MoreThis study aims at identifying the reality of alternative assessment for teachers of the first cycle of the basic education in the Sultanate of Oman with respect to the degree of teachers' use of alternative assessment strategies, level of self-efficacy for alternative assessment strategies, and attitude towards alternative assessment, and their relationship with other variables. To achieve the aims of the study, a descriptive research approach was utilized. A 5-point self-rated questionnaire was developed. It consists of three sections: Actual use of alternative assessment strategies (21 items), self-efficacy for alternative assessment strategies (21 items), and attitude towards alternative assessment (27 items). The psychometric proper
... Show MoreMost recognition system of human facial emotions are assessed solely on accuracy, even if other performance criteria are also thought to be important in the evaluation process such as sensitivity, precision, F-measure, and G-mean. Moreover, the most common problem that must be resolved in face emotion recognition systems is the feature extraction methods, which is comparable to traditional manual feature extraction methods. This traditional method is not able to extract features efficiently. In other words, there are redundant amount of features which are considered not significant, which affect the classification performance. In this work, a new system to recognize human facial emotions from images is proposed. The HOG (Histograms of Or
... Show MoreGangyong Lee, S.Tariq Rizvi, and Cosmin S.Roman studied Rickart modules.
The main purpose of this paper is to develop the properties of Rickart modules .
We prove that each injective and prime module is a Rickart module. And we give characterizations of some kind of rings in term of Rickart modules.
In this article we derive two reliability mathematical expressions of two kinds of s-out of -k stress-strength model systems; and . Both stress and strength are assumed to have an Inverse Lomax distribution with unknown shape parameters and a common known scale parameter. The increase and decrease in the real values of the two reliabilities are studied according to the increase and decrease in the distribution parameters. Two estimation methods are used to estimate the distribution parameters and the reliabilities, which are Maximum Likelihood and Regression. A comparison is made between the estimators based on a simulation study by the mean squared error criteria, which revealed that the maximum likelihood estimator works the best.
Roughness length is one of the key variables in micrometeorological studies and environmental studies in regards to describing development of cities and urban environments. By utilizing the three dimensions ultrasonic anemometer installed at Mustansiriyah university, we determined the rate of the height of the rough elements (trees, buildings and bridges) to the surrounding area of the university for a radius of 1 km. After this, we calculated the zero-plane displacement length of eight sections and calculated the length of surface roughness. The results proved that the ranges of the variables above are ZH (9.2-13.8) m, Zd (4.3-8.1) m and Zo (0.24-0.48) m.
The Research Aims To Clarify The Role Of Knowledge Innovation On The Administrative Process Represented by Managing Strategic Momentum, The Research Problem Focuses on Administrative leader Interest In And Implementation Of The Innovation Element Of Knowledge In The Organization By " Managing Strategic Momentum" As Well As The Focus By Management About The Innovators And Makers Of Knowledge And Strategic Planners In The Design And Formulation Of Strategic. Research does Contribute In Solving Part Of The Organizational Problems Of Vision, Innovation And Their Impact On The Momentum Management To Determine The Extent On Which The Procedures Of The Assessed Companies And Plan To Regulate Innovation Under The Momentu
... Show MoreThe importance of research and study of classical Persian literature is not overlooked. So far, there have been many studies in this area. But there are still some things that need more research. Persian grammar is one of the most important branches of Persian literature. This section has always been converted at different times. One of the issues that has been neglected in the studies of classical literature is the study of the technical tales of past and past poetry. These texts can be studied from different perspectives. Because Persian is a mixed language, it is possible to combine language terms with each other or to add prefixes and suffixes to express new concepts. They can be used by exam
... Show MoreA progressive increase in the desire for environmentally friendly lubricants by users and strict government regulations for the use of these lubricants has provided an opportunity to use plant oils as biodegradable lubricants, therefore vegetable oils have been investigated to replace oil lubricants because of their maintaining the conditions of nature (environment) properties. In this paper, the influences of the blending ratio of mustard seeds oil with commercial mineral oil (SAE40) on the tribological characteristics were investigated and compared with mineral oil using the four-ball tribotester. Mustard seeds oil was blended with mineral oil at a volumetric ratio ranging from 22.5 to 90%. All experimental works were
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