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 present paper sheds light on irony as one of the most important and most common linguistic phenomena in modern linguistics, in general ,and in discourse in particular, whether it is (political, literary, journalistic, etc.). When irony is used correctly or positively, it paves the way for the speaker to gain the approval of other parties participating in the dialogue and dissolve barriers between them. It is a simple multi-functional linguistic style and an expression of one’s meaning by using language that normally signifies the opposite according to the context and the situation. Therefore, it is necessary to study its characteristics, define its functions and traces the extent of
... Show MoreThe estimation of the parameters of linear regression is based on the usual Least Square method, as this method is based on the estimation of several basic assumptions. Therefore, the accuracy of estimating the parameters of the model depends on the validity of these hypotheses. The most successful technique was the robust estimation method which is minimizing maximum likelihood estimator (MM-estimator) that proved its efficiency in this purpose. However, the use of the model becomes unrealistic and one of these assumptions is the uniformity of the variance and the normal distribution of the error. These assumptions are not achievable in the case of studying a specific problem that may include complex data of more than one model. To
... Show MoreThe present paper deals with studying the effect of electrical discharge machining (EDM) and shot blast peening parameters on work piece fatigue lives using copper and graphite electrodes. Response surface methodology (RSM) and the design of experiment (DOE) were used to plan and design the experimental work matrices for two EDM groups of experiments using kerosene dielectric alone, while the second was treated by the shot blast peening processes after EDM machining. To verify the experimental results, the analysis of variance (ANOVA) was used to predict the EDM models for high carbon high chromium AISI D2 die steel. The work piece fatigue lives in terms of safety factors after EDM models were developed by FEM using ANSY
... Show MoreThe paper is devoted to solve nth order linear delay integro-differential equations of convolution type (DIDE's-CT) using collocation method with the aid of B-spline functions. A new algorithm with the aid of Matlab language is derived to treat numerically three types (retarded, neutral and mixed) of nth order linear DIDE's-CT using B-spline functions and Weddle rule for calculating the required integrals for these equations. Comparison between approximated and exact results has been given in test examples with suitable graphing for every example for solving three types of linear DIDE's-CT of different orders for conciliated the accuracy of the results of the proposed method.
Rock engineers widely use the uniaxial compressive strength (UCS) of rocks in designing
surface and underground structures. The procedure for measuring this rock strength has been
standardized by both the International Society for Rock Mechanics (ISRM) and American Society
for Testing and Materials (ASTM), Akram and Bakar(2007).
In this paper, an experimental study was performed to correlate of Point Load Index ( Is(50))
and Pulse Wave Velocity (Vp) to the Unconfined Compressive Strength (UCS) of Rocks. The effect
of several parameters was studied. Point load test, Unconfined Compressive Strength (UCS) and
Pulse Wave Velocity (Vp) were used for testing several rock samples with different diameters.
The predicted e
A confluence of forces has brought journalism and journalism education to a precipice. The rise of fascism, the advance of digital technology, and the erosion of the economic foundation of news media are disrupting journalism and mass communication (JMC) around the world. Combined with the increasingly globalized nature of journalism and media, these forces are posing extraordinary challenges to and opportunities for journalism and media education. This essay outlines 10 core principles to guide and reinvigorate international JMC education. We offer a concluding principle for JMC education as a foundation for the general education of college students.
The nucleon momentum distributions (NMD) and elastic electron scattering form factors of the ground state for some 1f-2p-shell nuclei, such as 58Ni, 60Ni, 62Ni, and 64Ni
isotopes have been calculated in the framework of the coherent fluctuation model (CFM) and expressed in terms of the weight function lf(x)l2 . The weight function (fluctuation function) has been related to the nucleon density distribution (NDD) of the nuclei and determined from the theory and experiment. The NDD is derived from a simple method based on the use of the single particle wave functions of the harmonic oscillator potential and the occupation numbers of the states. The feature of the l
It 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 MoreUsing the Neural network as a type of associative memory will be introduced in this paper through the problem of mobile position estimation where mobile estimate its location depending on the signal strength reach to it from several around base stations where the neural network can be implemented inside the mobile. Traditional methods of time of arrival (TOA) and received signal strength (RSS) are used and compared with two analytical methods, optimal positioning method and average positioning method. The data that are used for training are ideal since they can be obtained based on geometry of CDMA cell topology. The test of the two methods TOA and RSS take many cases through a nonlinear path that MS can move through that region. The result
... Show MoreIraq depends mainly on Tigris and Euphrates Rivers to provide high percentage of agricultural water use for thousands years. At last years, Iraq is suffering from shortage in water resources due to global climate changes and unfair water politics of the neighboring countries, which affected the future of agriculture plans for irrigation, added to that the lack of developed systems of water management in the irrigation projects and improper allocation of irrigation water, which reduces water use efficiency and lead to losing irrigation water and decreasing in agricultural yield. This study aims at studying the usability of irrigation and leaching scheduling within the irrigating projects and putting a complete annual or seasonal irrigatio
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