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.
В статье рассматривается вопрос о связи флективных изменений с мыслительными процессами на материале русского и арабского языков, анализируются семантические, фонетические, морфологические и синтаксические основы фонограмматической когниции. Цель статьи выявление прямой связи между количественным звуковым изменением согласного состава слова и мыслительными процессами, с помощью которых человеческ
... Show MoreThe ground state densities of unstable neutron-rich 8He and 17B exotic nuclei are studied via the framework of the two-frequency shell model (TFSM) and the binary cluster model (BCM). In TFSM, the single particle harmonic oscillator wave functions are used with two different oscillator size parameters βc and βv where the former is for the core (inner) orbits and the latter is for the valence (halo) orbits. In BCM, the internal densities of the clusters are described by single particle Gaussian wave functions. Shell model calculations for the two valence neutrons in 8He and 17B are performed via the computer code OXBASH. The long tail performance is clearly noticed in the calculated neutron and matter density distributions of these nucl
... Show MoreThe concept of closed quasi principally injective acts over monoids is introduced ,which signifies a generalization for the quasi principally injective as well as for the closed quasi injective acts. Characterization of this concept is intended to show the behavior of a closed quasi principally injective property. At the same time, some properties of closed quasi principally injective acts are examined in terms of their endomorphism monoid. Also, the characterization of a closed self-principally injective monoid is given in terms of its annihilator. The relationship between the following concepts is also studied; closed quasi principally injective acts over monoids, Hopfian, co Hopfian, and directly finite property. Ultimately, based on
... Show MoreThe legal protection of the human genome is an ethical issue related to the future of human existence. After the disclosure of the human genetic map, scientific practices and research related to the human genome increased, especially the negative applications of genetic engineering that violates basic human rights, especially the right to human dignity, and pose real challenges to the existence and diversity of Present and future generations. Therefore, the existence of legal rules at the national and international levels is an absolute necessity to prohibit these threats and to arrange civil and criminal liability for those who violate them.
The research aims at clarifying the role of green human resource management practices in achieving sustainable development. The research problem is that the health sector is less concerned with environmental aspects, specifically green human resource management practices, Which are reflected on sustainable development with their economic, environmental and social dimensions as well as reducing costs, waste minimization and recycling, And the research started from two main hypotheses to explore the correlation and influence between the variables of the research by analyzing the answers of the research sample, which included (136) employees of the Al-Imamein Al-kadhemein medical city, Data and information were collected using quest
... Show MoreThe interest of many companies has become dealing with the tools and methods that reduce the costs as one of the most important factors of successful companies, and became the subject of the attention of many economic units because of the impact on the profits of company, and since the nineties of the last century the researchers and writers gave great attention to this subject, especially in light of the large competition and rapid developments in cost management techniques, as well as the wide and significant change in production methods that have been directed towards achieving customer satisfaction, all this and more driven by economic units in all sectors whether it is service or productivity to find methods that would reduc
... Show MoreThe article examines the definition of the verb in the form of the imperative mood (imperative) _ general information about the verb in Russian .
A verb in Russian is one of the parts of speech that unify all parts of speech, expressing the meaning of action, movement, process in grammatical forms of time, type, mood, face and voice. The imperative mood is a grammatical feature of the verb expressed through several forms of the verb that urges someone to do things. In other words, imperative mood or (imperative) : - one of the single meaning of the form . The form of the imperative expresses a supplicatio
... Show MoreThe author addresses the issue of the linguoculturological component in the process of teaching Russian to Arabic students, focuses on the peculiarities of the national character of students. The author also refers to the long-standing ties of Russian and Arab cultures, thus emphasizing the relevance of this aspect for the current state and situation of the Russian language in Arab countries.
Автор статьи обращается к вопросу лингвокультурологической составляющей в процессе преподавания русского языка арабским студентам, останавливается на особенностях национального хара
... Show MoreBackground: Alcohol remains the single most significant cause of liver disease throughout the Western world, responsible for between 40 and 80% of cases of cirrhosis in different countries. Many of the factors underlying the development of alcoholic liver injury remain unknown, and significant questions remain about the value of even very basic therapeutic strategies.
Patients and Methods: In a cross sectional study, 113 alcoholic patients with evidence of liver disease in the absence of other significant etiology attending the Gastoenterorology and Hepatology Teaching Hospital between December 2001 and December 2003 were studied for the hematological and biochemical spectrum of alcoholic liver disease in