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 aim of this paper is to study the Zariski topology of a commutative KU-algebra. Firstly, we introduce new concepts of a KU-algebra, such as KU-lattice, involutory ideal and prime ideal and investigate some basic properties of these concepts. Secondly, the notion of the topology spectrum of a commutative KU-algebra is studied and several properties of this topology are provided. Also, we study the continuous map of this topological space.
A new human-based heuristic optimization method, named the Snooker-Based Optimization Algorithm (SBOA), is introduced in this study. The inspiration for this method is drawn from the traits of sales elites—those qualities every salesperson aspires to possess. Typically, salespersons strive to enhance their skills through autonomous learning or by seeking guidance from others. Furthermore, they engage in regular communication with customers to gain approval for their products or services. Building upon this concept, SBOA aims to find the optimal solution within a given search space, traversing all positions to obtain all possible values. To assesses the feasibility and effectiveness of SBOA in comparison to other algorithms, we conducte
... Show MoreThe concept of the order sum graph associated with a finite group based on the order of the group and order of group elements is introduced. Some of the properties and characteristics such as size, chromatic number, domination number, diameter, circumference, independence number, clique number, vertex connectivity, spectra, and Laplacian spectra of the order sum graph are determined. Characterizations of the order sum graph to be complete, perfect, etc. are also obtained.
This paper is specifically a detailed review of the Spatial Quantile Autoregressive (SARQR) model that refers to the incorporation of quantile regression models into spatial autoregressive models to facilitate an improved analysis of the characteristics of spatially dependent data. The relevance of SARQR is emphasized in most applications, including but not limited to the fields that might need the study of spatial variation and dependencies. In particular, it looks at literature dated from 1971 and 2024 and shows the extent to which SARQR had already been applied previously in other disciplines such as economics, real estate, environmental science, and epidemiology. Accordingly, evidence indicates SARQR has numerous benefits compar
... Show MoreTheauthor addressed politeness discourse in “Surat Ghafir”. Quran texts include many rhetorical utterances which are considered pragmatic mechanismsconcerned with finding polite discourse. examining these texts allow to determine the effectiveness degree in the discourse, and to find the effect level that leads to interaction between the speaker and the listener. Graduation is considered an effect and a mechanism of discourse escalation.
The author reached a common definition of the graduation effectiveness term, due to its importance in finding polite discourse that is constructed by lingual manifestations some of which are escalation and graduation. Escalation is a mechanism to show the level of discourse graduation, it is a mea
This research basically gives an introduction about the multiple intelligence
theory and its implication into the classroom. It presents a unit plan based upon the
MI theory followed by a report which explains the application of the plan by the
researcher on the first class student of computer department in college of sciences/
University of Al-Mustansiryia and the teacher's and the students' reaction to it.
The research starts with a short introduction about the MI theory is a great
theory that could help students to learn better in a relaxed learning situation. It is
presented by Howard Gardener first when he published his book "Frames of
Minds" in 1983 in which he describes how the brain has multiple intelligen
Sheet piles are necessary with hydraulic structures as seepage cut-off to reduce the seepage. In this research, the computational work methodology was followed by building a numerical model using Geo-Studio program to check the efficiency of using concrete sheet piles as a cut-off or reducer for seepage with time if the sheet piles facing the drawdown technique. Al-Kifil regulator was chosen as a case study, an accurate model was built with a help of observed reading of the measuring devices, which was satisfactory and helped in checking the sheet piles efficiency. Through the study, three scenarios were adopted (with and without) drawdown technique, it was found that at the short time there's no effect of the drawdown technique on
... Show MoreThe current research includes a look at the participation of Iraqi women in the combat roles, which starts from the assumption of the democratic transition that must be led - in one of its aspect - until the army or the military foundation to become a "citizen army," the matter which is represented a demand increasingly needed in the experiences of Democratic transformation that facing serious security challenges such as in Iraq, this means that the army or security foundation - which is involved in counterterrorism - should not reflect a specific group in society , and hence embody the most important democratic principles, which are equality and equal opportunities, especially gender equality. On the other hand, the influence of armed conf
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