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.
This paper tackles tragedy and grief in the Hebrew poetry of the Middle Ages, as being topics which was transferred to it from Arabic poetry at that time. This came as a result of Hebrew poets quoting images from, and adopting the form and content of the Arabic poem. So, this topic was a prominent feature in the Hebrew poetry of the middle ages. The Hebrew poets focused upon this topic along three trends: poems of lamentation, whether being what are called national lamentation where poets expressed their feelings and grieves because of their remoteness and longing to their homeland, which is Palestine or the sacred land, as they claim; here, Zionist trends were apparent in many poems lamenting Zion and other cities. The other type of poe
... Show MoreThe effect of the tensor term in the Skyrme interaction has been estimated in calculating the static and dynamic nuclear properties in sd and fp-shell model spaces nuclei. The nuclear shell gaps have been studied with different Skyrme parameterizations; Skxta and Skxtb with tensor interaction, SkX, SkM, and SLy4 without tensor interaction, and Skxcsb with consideration of the effect of charge symmetry breaking. We have examined the stability of N = 28 for 42Si and 48Ca. The results showed that the disappearance of the magicity occurs in the shell closure of 42Si. Furthermore, excitation energy, quadrupole deformation, neutron separation energy, pairing energy, and density profile have also been calculated. Quadrupole deformation indicates a
... Show MoreIn this research, an unknown space-dependent force function in the wave equation is studied. This is a natural continuation of [1] and chapter 2 of [2] and [3], where the finite difference method (FDM)/boundary element method (BEM), with the separation of variables method, were considered. Additional data are given by the one end displacement measurement. Moreover, it is a continuation of [3], with exchanging the boundary condition, where are extra data, by the initial condition. This is an ill-posed inverse force problem for linear hyperbolic equation. Therefore, in order to stabilize the solution, a zeroth-order Tikhonov regularization method is provided. To assess the accuracy, the minimum error between
... Show MoreIn this paper, we develop the work of Ghawi on close dual Rickart modules and discuss y-closed dual Rickart modules with some properties. Then, we prove that, if are y-closed simple -modues and if -y-closed is a dual Rickart module, then either Hom ( ) =0 or . Also, we study the direct sum of y-closed dual Rickart modules.
The current study seeks to evaluate teacher preparation programs in the scientific disciplines at the College of Education in Al-Aqsa University in the light of the requirements of the labor market. It further aims to reveal the significance of the differences in the sample members’ response averages of to the availability of labor market requirements in the program that prepares the teacher of scientific disciplines at the Faculty of Education in Al-Aqsa University taking into account the (gender, program) variables. The study followed the descriptive analytical approach, and so a questionnaire was distributed to a sample of scientific discipline students in the teacher preparation program adopted in Al-Aqsa University, (200) male and
... Show MoreThere are Islamic sources and books that deal with the different doctrinal and differential framework of the Islamic religion with a monistic approach, describing them with embarrassing jurisprudential titles such as: excommunication and expiation, and epithets that carry the characteristics of hatred and rejection, in addition to removing them from the sect and religion, and the reason for that is that the doctrine (A) or (b) considers itself the doctrine that represents only the Islamic religion, and other doctrines are misguided and disbelieving. the reasons behind this - besides the attempt to establish doctrinal and fiqih rooting in claiming truth and escaping from within the foundational differential doctrinal system – is the pol
... Show MoreIn this paper, a new technique is offered for solving three types of linear integral equations of the 2nd kind including Volterra-Fredholm integral equations (LVFIE) (as a general case), Volterra integral equations (LVIE) and Fredholm integral equations (LFIE) (as special cases). The new technique depends on approximating the solution to a polynomial of degree and therefore reducing the problem to a linear programming problem(LPP), which will be solved to find the approximate solution of LVFIE. Moreover, quadrature methods including trapezoidal rule (TR), Simpson 1/3 rule (SR), Boole rule (BR), and Romberg integration formula (RI) are used to approximate the integrals that exist in LVFIE. Also, a comparison between those
... Show MoreThis paper offers a critical examination of Canadian news guidelines and policies
on user-generated content (UGC) posted on news-related comment sections and
social media.
The outline of how news-related UGC is moderated within Canadian news is achieved
by looking at the online comment policies of major Canadian news organizations like .
the CBC, CityNews (Halifax), CTV News, Glacier Media, Global News, The Globe
and Mail, Narcity Media, Postmedia, QUB (Québecor), and Torstar.The policies highlight how Canadian news organizations have practical strategies
to manage news-related UGC but also call upon positive and negative social
principles, to flag ill practices, foster democracy, and fight against online hate sp
This research display a selected sample of Regelson's texts, there were interrelations and interactions unfolded so as to show his creativity in the employment of religious texts. In the story "In the Youth of Moses", he inter-texted the episode of the Prophet Moses from the Torah, the Source of legislation, to signify a legislative issue needed by the community. As for the story of "Samson, One of the Falling", he originated the character of The Judge Samson by alluding to the Book of the Judges, which is the Book which reminded of the defeat and slavery of the Palestinians by a Jewish leader, as is related in Jewish religious texts. Further, and the story of "And Haman Said", he chose the story of the Queen Esther from the Book of Esth
... Show MoreSegmented regression consists of several sections separated by different points of membership, showing the heterogeneity arising from the process of separating the segments within the research sample. This research is concerned with estimating the location of the change point between segments and estimating model parameters, and proposing a robust estimation method and compare it with some other methods that used in the segmented regression. One of the traditional methods (Muggeo method) has been used to find the maximum likelihood estimator in an iterative approach for the model and the change point as well. Moreover, a robust estimation method (IRW method) has used which depends on the use of the robust M-estimator technique in
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