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 Disi water samples were collected from different Disi aquifer wells in Jordan using a clean polyethylene container of 10-liter size. A hyper-pure germanium (HPGe) detector with high- resolution gamma-ray spectroscopy and a low background counting system was used for the identification of unknown gamma-rays emitting from radionuclides in the environmental samples. The ranges of specific activity concentrations of 226Ra and 228Ra in the Disi aquifer water were found to be from 0.302 ± 0.085 to 0.723 ± 0.207 and from 0.047 ± 0.010 to 0.525 ± 0.138 Bq L−1, with average values of 0.516 ± 0.090 and 0.287 ± 0.091 Bq L−1, respectively. The average combined radium (226Ra + 228Ra) activity and radium activity ratio (228Ra/226Ra) in Disi
... Show MoreIt is a common Knowledge that adverbs in Turkish languages can modify verbs, adjectives, nouns or other adverbs. Moreover, adverbs can determine the meanings of nouns and verbs in a sentence as far as time, place, manner, quantity and interrogative are concerned. The present study debates adverbs’ functions in Namiq Kamal’s play Vatan yahut Silistre.
The study sheds light on the author’s use of the adverbs to describe the required theatrical actions of the play and to convey his reflections and thoughts easily to the auidence. One of the main hindrances encountered in conducting the study is the shortage of the upto date academic resources necessary for
... Show MoreThe main purpose of this work is to introduce some types of fuzzy convergence sequences of operators defined on a standard fuzzy normed space (SFN-spaces) and investigate some properties and relationships between these concepts. Firstly, the definition of weak fuzzy convergence sequence in terms of fuzzy bounded linear functional is given. Then the notions of weakly and strongly fuzzy convergence sequences of operators are introduced and essential theorems related to these concepts are proved. In particular, if ( ) is a strongly fuzzy convergent sequence with a limit where linear operator from complete standard fuzzy normed space into a standard fuzzy normed space then belongs to the set of all fuzzy bounded linear operators
Angle of arrival (AOA) estimation for wideband signal becomes more necessary for modern communication systems like Global System for Mobile (GSM), satellite, military applications and spread spectrum (frequency hopping and direct sequence). Most of the researchers are focusing on how to cancel the effects of signal bandwidth on AOA estimation performance by using a transversal filter (tap delay line) (TDL). Most of the researchers were using two elements array antenna to study these effects. In this research, a general case of proposed (M) array elements is used. A transversal filter (TDL) in phase adaptive array antenna system is used to calculate the optimum number of taps required to compensate these effect. The propo
... Show MoreThe objective of this work is to study the concept of a fuzzy -cone metric space And some related definitions in space. Also, we discuss some new results of fixed point theorems. Finally, we apply the theory of fixed point achieved in the research on an integral type.
The current environment is witnessing several developments as a result of the changes taking place in all areas of economic, social , political and legal that led to the transformation of the industrial economy , which depends based on quantitative production to a knowledge economy which relies based on information and knowledge , as the central pillar of this economy during the trading of these information and knowledge between all individuals in general and decision makers , in particular, through information and communication technology of computers and the Internet to achieve sustainable human development in the social dimension. &
... Show MoreThe study seeks to identify e-governance requirements in human resources management, which are (administrative requirements, technical, human, financial, and security) which is a new style differs from the traditional management pattern, where work depends on multiple forms and methods of Tools, (e. g. computers and various electronic software), by relying on powerful information systems that help to make management decisions as quickly and less effortless and less expensive to keep up with the tremendous technological advancements in the field of information and communication technology revolution.
The sample included 132 Person who constitute a position (Director General, assistant Director General, section managers and d
... Show More"The aim of the research is to identify the availability of the dimensions of the research variables represented by organizational symmetry and the quality of work-life at the University of Information and Communications Technology, which is one of the formations of the Ministry of Higher Education and Scientific Research in Baghdad, in addition to knowing the relationship and influence between them. The research relied on the descriptive analytical approach based on peer description. The research was analyzed and the research sample consisted of (148) individuals, the sample was chosen using the comprehensive inventory method, data was obtained by relying on the questionnaire which was prepared from ready-made m
... Show MoreIn this study, we propose a suitable solution for a non-linear system of ordinary differential equations (ODE) of the first order with the initial value problems (IVP) that contains multi variables and multi-parameters with missing real data. To solve the mentioned system, a new modified numerical simulation method is created for the first time which is called Mean Latin Hypercube Runge-Kutta (MLHRK). This method can be obtained by combining the Runge-Kutta (RK) method with the statistical simulation procedure which is the Latin Hypercube Sampling (LHS) method. The present work is applied to the influenza epidemic model in Australia in 1919 for a previous study. The comparison between the numerical and numerical simulation res
... Show MoreBackground: As photochemical reaction that can stiffen the cornea, CXL is the only promising method of preventing progression of keratectasia such as KC and secondary ectasia following refractive surgery. The aim of CXL is to stabilize the underlying condition with a small chance of visual improvement. Objective: To show the sequences of changes in visual acuity and topographic outcomes during 1 year post CXL for patients with progressive Keratoconus.Type of the study: Cross sectional studyMethods: CXL procedure was done for 45 eyes with progressive KC. The following parameters had been monitored pre operatively, 1, 3, 6 and 12 months postoperatively: K apex, K2, corneal thickness at thinnest location, anterior and posterior elevation po
... Show More