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 electric quadrupole moments for some nitrogen isotopes (12,14,15,16,18N) are
studied by shell model calculations with the proton-neutron formalism. Theoretical
calculations performed using the different set of effective charges due to the core
polarization effect. The effective charges in the p-shell nuclei are found to be
slightly different from those in the sd-shell nuclei. Most of the results we have
obtained are underestimated with the measured data for the isotopes considered in
this work.
This research includes the use of an artificial intelligence algorithm, which is one of the algorithms of biological systems which is the algorithm of genetic regulatory networks (GRNs), which is a dynamic system for a group of variables representing space within time. To construct this biological system, we use (ODEs) and to analyze the stationarity of the model we use Euler's method. And through the factors that affect the process of gene expression in terms of inhibition and activation of the transcription process on DNA, we will use TF transcription factors. The current research aims to use the latest methods of the artificial intelligence algorithm. To apply Gene Regulation Networks (GRNs), we used a progr
... Show More
The aim of this paper is to estimate a single reliability system (R = P, Z > W) with a strength Z subjected to a stress W in a stress-strength model that follows a power Rayleigh distribution. It proposes, generates and examines eight methods and techniques for estimating distribution parameters and reliability functions. These methods are the maximum likelihood estimation(MLE), the exact moment estimation (EMME), the percentile estimation (PE), the least-squares estimation (LSE), the weighted least squares estimation (WLSE) and three shrinkage estimation methods (sh1) (sh2) (sh3). We also use the mean square error (MSE) Bias and the mean absolute percentage error (MAPE) to compare the estimation methods. Both theoretical c
... Show More
(6)
(3)
Soft closure spaces are a new structure that was introduced very recently. These new spaces are based on the notion of soft closure operators. This work aims to provide applications of soft closure operators. We introduce the concept of soft continuous mappings and soft closed (resp. open) mappings, support them with examples, and investigate some of their properties.
(3)
(2)
تهدف هذه الدراسة للتعرف على السياسات اإلاسرائيلية المتبعة على الارض والمتمثلة في االاستيطان
الاستعماري والطرق التفافية، ومصادرة الاراضي وجدار الضم والتوسع العنصري، بالاضافة إلى التصنيف
الاداري للمناطق في الضفة الغربية حسب ما جاء في اتفاقية أوسلو، والتي من شأنها التأثير على تلك
المناطق، وال سيما قطاع اإلسكان الذي يعد من أهم القطاعات التي تتر كب وبالتحديد في منطقة الدراسة،
وسوف تحاول هذه الدراسة تس
Let R be a commutative ring with identity and E be a unitary left R – module .We introduce and study the concept Weak Pseudo – 2 – Absorbing submodules as generalization of weakle – 2 – Absorbing submodules , where a proper submodule A of an R – module E is called Weak Pseudo – 2 – Absorbing if 0 ≠rsx A for r, s R , x E , implies that rx A + soc ( E ) or sx A + soc (E) or rs [ A + soc ( E ) E ]. Many basic properties, char
... Show More
Let G be a graph, each edge e of which is given a weight w(e). The shortest path problem is a path of minimum weight connecting two specified vertices a and b, and from it we have a pre-topology. Furthermore, we study the restriction and separators in pre-topology generated by the shortest path problems. Finally, we study the rate of liaison in pre-topology between two subgraphs. It is formally shown that the new distance measure is a metric
The national educational systems both in the Russian Federation and Iraq Republic have to adjust the training programs to duly prepare the pedagogical university students for the modern challenges and situations on the market of educational services. For success of the service, the education specialists have to fully mobilize their physical, mental and emotional resources and persistently advance their skills and knowledge using the relevant online education courses; practical research conferences; persistent self-education to master theoretical fundamentals of the modern physical education and sport service; and be active in trainings and competitions in their vocational individual game sports including badminton, table tennis and tennis.
... Show MoreIn this paper, we introduce new definitions of the - spaces namely the - spaces Here, and are natural numbers that are not necessarily equal, such that . The space refers to the n-dimensional Euclidean space, refers to the quaternions set and refers to the N-dimensional quaternionic space. Furthermore, we establish and prove some properties of their elements. These elements are quaternion-valued N-vector functions defined on , and the spaces have never been introduced in this way before.