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 aims at providing the teaching staff members with the necessary skills so as to become capable of tackling various situations, and treating daily problems that face students learning Spanish as a Second Language. This is made as an attempt to make teachers of foreign languages in general acquainted with modern trends of teaching with less complicated methods, specifically in teaching e earlier stages of foreign languages.
Abstracto:
En el presente trabajo pretendemos dotar al docente no nativo de Lenguas extranjeras, con algunos de los métodos necesari
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Anaemia is a common extra-articular manifestation of rheumatoid arthritis (RA) where anaemia of chronic disease (ACD) and iron deficiency anaemia (IDA) are the two most frequent types. The distinction between these two types of anaemia has always been challenging requiring sophisticated techniques. Serum transferrin receptor (sTfR) a truncated soluble form of the transferrin receptor is one of the parameters that is influenced by the Iron content and supply to the erythrons and is not affected by inflammatory status and therefore the use of the sTfR/log ferritin (sTfR-F) index can be a reliable indicator of functional iron deficiency.
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This paper introduces the Multistep Modified Reduced Differential Transform Method (MMRDTM). It is applied to approximate the solution for Nonlinear Schrodinger Equations (NLSEs) of power law nonlinearity. The proposed method has some advantages. An analytical approximation can be generated in a fast converging series by applying the proposed approach. On top of that, the number of computed terms is also significantly reduced. Compared to the RDTM, the nonlinear term in this method is replaced by related Adomian polynomials prior to the implementation of a multistep approach. As a consequence, only a smaller number of NLSE computed terms are required in the attained approximation. Moreover, the approximation also converges rapidly over a
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The effect of short range correlations on the inelastic longitudinal Coulomb form
factors for the lowest four excited 2+ states in 18O is analyzed. This effect (which
depends on the correlation parameter β) is inserted into the ground state charge
density distribution through the Jastrow type correlation function. The single particle
harmonic oscillator wave function is used with an oscillator size parameter b. The
parameters β and b are, considered as free parameters, adjusted for each excited state
separately so as to reproduce the experimental root mean square charge radius of
18O. The model space of 18O does not contribute to the transition charge density. As
a result, the inelastic Coulomb form factor of 18
The research aimed to prepare muscle elongation exercises for the arms with high intensity in which the training methods for young blind fencers vary, and to identify the effect of the diversity of muscle elongation exercises for the arms with high intensity on the cellular basal efficiency (lactic acid and sodium bicarbonate) and pulmonary respiration for young blind weapon fencers in terms of sports technology, and the experimental approach was adopted by designing the experimental and equal control groups, and the limits of the research community were represented by young fencers with shish weapon under the age of (20) years in the Army Sports Club, whose number is Total (15) swordsmen, continuing their training for the sports season (20
... Show MoreАрхив всех научных статей сборников конференций и журналов по направлению Филология.
ملخص البحث:
ان الله تعالى هو الذي خلق جميع المخلوقات ، والذي بيده الموت والحياة وان كل هذه المخلوقات تحتاج الى اوامر ، وهذه الاوامر الالهية وجهها الله لعبادة بوساطة انبياءه ( عليهم السلام) فكانوا هم اول المستسلمين والمنقادين لأوامره ، فجاءت الآيات الكريمة مخاطبة للأنبياء واقوامهم بشكل عام ولنبينا محمد (r) بشكل خاص.
اما عن المضمون البحثي فقد جاءت مادته مقسمة الى ثل
... Show MoreIn 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.
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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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,
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