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.
Background: Neonatal seizures are the most common neurological emergency in newborns, often associated with significant mortality and long-term neurodevelopmental disabilities. The aim is to determine the incidence, etiological causes, and risk factors associated with neonatal seizures.Patients and Methods: This prospective case-control study was conducted over eight months, from January 1 to August 31, 2022, the study was conducted at the neonatal care unit of Children Welfare Teaching Hospital. Neonates who developed clinically recognizable seizures before 28 days of life in term infants, or up to 44 weeks corrected gestational age in preterm infants, were included. Data collection involved demographic information, prenatal, perin
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The traditional centralized network management approach presents severe efficiency and scalability limitations in large scale networks. The process of data collection and analysis typically involves huge transfers of management data to the manager which cause considerable network throughput and bottlenecks at the manager side. All these problems processed using the Agent technology as a solution to distribute the management functionality over the network elements. The proposed system consists of the server agent that is working together with clients agents to monitor the logging (off, on) of the clients computers and which user is working on it. file system watcher mechanism is used to indicate any change in files. The results were presente
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In this research, we highlight the most important research related to the mixed ligand complexes of the drug trimethoprim (TMP), and for the past 7 years where this drug has been used as a chelating ligand and gives stability to the complexes with ions of metal elements where these complexes, prepared and diagnosed, and for some research the bacterial activity was studied against different types of bacteria
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Over the past few years, ear biometrics has attracted a lot of attention. It is a trusted biometric for the identification and recognition of humans due to its consistent shape and rich texture variation. The ear presents an attractive solution since it is visible, ear images are easily captured, and the ear structure remains relatively stable over time. In this paper, a comprehensive review of prior research was conducted to establish the efficacy of utilizing ear features for individual identification through the employment of both manually-crafted features and deep-learning approaches. The objective of this model is to present the accuracy rate of person identification systems based on either manually-crafted features such as D
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The present research aimed to test the imagination of children, and may build sample consisted of (400) a baby and child, selected by random way of four Directorates (first Resafe, second Resafe ,first alkarkh , second alkarkh), in order to achieve the objective of research the tow researchers have a test of imagination and extract the virtual and honesty plants distinguish paragraphs and paragraphs and difficulty factor became the test consists of (32), statistical methods were used (Pearson correlation coefficient, coefficient of difficult passages, highlight paragraphs, correlation equation, an equation wrong Standard) the tow researchers have a number of recommendations and proposals.
: Sound forecasts are essential elements of planning, especially for dealing with seasonality, sudden changes in demand levels, strikes, large fluctuations in the economy, and price-cutting manoeuvres for competition. Forecasting can help decision maker to manage these problems by identifying which technologies are appropriate for their needs. The proposal forecasting model is utilized to extract the trend and cyclical component individually through developing the Hodrick–Prescott filter technique. Then, the fit models of these two real components are estimated to predict the future behaviour of electricity peak load. Accordingly, the optimal model obtained to fit the periodic component is estimated using spectrum analysis and Fourier mod
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يهتم هذا البحث بدراسة الأجوبة المسكتة,وهي أجوبة سريعة وحاسمة تقطع حجة الخصم وتفحمه وتغلقالحوار.وقد أرتكز البحث على منهجية تداولية تنظرإلى فاعلية الجواب المسكت في المحاورة وإنهائها من زواياإنجازية و حجاجية.وقد تكون البحث من ديباجة ممهدةوثلاثة مباحث.وسلطتالديباجةالممهدةالضوء علىمفهومالجواب المسكتوشيوعهفي كتب الأدبوالأخبارونوادر الكلاموكيف يمكن النظر لهبوصفه وحدة حوارية تنبنيمنها المحادثة؟أما المبحث ا
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Debate is a teaching strategy in nursing education that enhances students' critical thinking. Although debate can be an effective teaching strategy, it is not without limitations. This article discusses the advantages and disadvantages of debate as a teaching strategy in nursing. Also, evaluating debates and choosing topics are highlighted.
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