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 surgery Keywords: Non-surgical treatment of anal fissure, fissure in ano, sphicterotomy,botulinum toxin in anal fissures, glyceryl trinitrate. Chemical sphincteratomy, pharmacological sphincteratomy.
يتكون الانحدار المقسم من عدة أقسام تفصل بينها نقاط انتماء مختلفة، فتظهر حالة عدم التجانس الناشئة من عملية فصل الأقسام ضمن عينة البحث. ويهتم هذا البحث في تقدير موقع نقطة التغيير بين الأقسام وتقدير معلمات الأنموذج، واقتراح طريقة تقدير حصينة ومقارنتها مع بعض الطرائق المستعملة في الانحدار الخطي المقسم. وقد تم استعمال أحد الطرائق التقليدية (طريقة Muggeo) لإيجاد مقدرات الإمكان الأعظم بالأسلوب الت
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Weibull distribution is considered as one of the most widely distribution applied in real life, Its similar to normal distribution in the way of applications, it's also considered as one of the distributions that can applied in many fields such as industrial engineering to represent replaced and manufacturing time ,weather forecasting, and other scientific uses in reliability studies and survival function in medical and communication engineering fields.
In this paper, The scale parameter has been estimated for weibull distribution using Bayesian method based on Jeffery prior information as a first method , then enhanced by improving Jeffery prior information and then used as a se
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The research, which was drawn from his doctoral thesis (People's Policy towards Vietnam 1949-1979), discussed the roots of the connections between the Chinese and Vietnamese communists since the 1920s, the presence of Ho Chi Minh and other Vietnamese communists in China, their influence by the revolutionary struggle of the Chinese Communist Party and their establishment of a group of The Vietnamese Revolutionary Societies and the Indo-Chinese Communist Party until the outbreak of the Vietnamese Revolution and their success in declaring the establishment of the Democratic Republic of Vietnam in 1946. Keywords: Ho Chi Minh, Chinese Communist Party, Indo-Chinese Communist Party, Democratic Republic of Vietnam, Chou En Lai.
Segmented regression consists of several sections separated by different points of membership, showing the heterogeneity arising from the process of separating the segments within the research sample. This research is concerned with estimating the location of the change point between segments and estimating model parameters, and proposing a robust estimation method and compare it with some other methods that used in the segmented regression. One of the traditional methods (Muggeo method) has been used to find the maximum likelihood estimator in an iterative approach for the model and the change point as well. Moreover, a robust estimation method (IRW method) has used which depends on the use of the robust M-estimator technique in
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Архив всех научных статей сборников конференций и журналов по направлению Филология.
The research aimed to prepare muscle elongation exercises for the arms with high intensity in which the training methods for young blind fencers vary, and to identify the effect of the diversity of muscle elongation exercises for the arms with high intensity on the cellular basal efficiency (lactic acid and sodium bicarbonate) and pulmonary respiration for young blind weapon fencers in terms of sports technology, and the experimental approach was adopted by designing the experimental and equal control groups, and the limits of the research community were represented by young fencers with shish weapon under the age of (20) years in the Army Sports Club, whose number is Total (15) swordsmen, continuing their training for the sports season (20
... Show MoreIn this research we been estimated the survival function for data suffer from the disturbances and confusion of Iraq Household Socio-Economic Survey: IHSES II 2012 , to data from a five-year age groups follow the distribution of the Generalized Gamma: GG. It had been used two methods for the purposes of estimating and fitting which is the way the Principle of Maximizing Entropy: POME, and method of booting to nonparametric smoothing function for Kernel, to overcome the mathematical problems plaguing integrals contained in this distribution in particular of the integration of the incomplete gamma function, along with the use of traditional way in which is the Maximum Likelihood: ML. Where the comparison on the basis of the method of the Cen
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The research is a vision of the future of industry in Iraq, so it is may be outside the ceiling of the capabilities of the Iraqi economy, and therefore it is exaggerated. Therefore, future plans must be applicable through the availability of capabilities. Everyone knows that the financial and administrative corruption and mismanagement of resources are the main cause of the inefficiency of the industrial sector, and the failure to exercise its real role in achieving economic development.; as well as the political situation and the dominance of parties and their insistence on addressing positions that have a strong relationship in managing the economic sector that has a significant impact on drawing the economic map in its current
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The chemical additives used to enhance the properties of drilling mud cause damage to humans and the environment. Therefore, it is necessary to search for alternative additives to add them to the drilling mud. Thus, this study investigates the effects of pomegranate peel and grape seed powders as natural waste when added to un-weighted water-based mud. The test includes measurements of the rheological properties and filtration, as well as the alkanity and density of the drilling mud. The results showed a decrease in PH values with an increase in the concentrations of pomegranate peel or grapeseed, and a decrease in mud density with an increase in powders of pomegranate peel and grape seed concentrations that resulted f
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This paper aims at providing the teaching staff members with the necessary skills so as to become capable of tackling various situations, and treating daily problems that face students learning Spanish as a Second Language. This is made as an attempt to make teachers of foreign languages in general acquainted with modern trends of teaching with less complicated methods, specifically in teaching e earlier stages of foreign languages.
Abstracto:
En el presente trabajo pretendemos dotar al docente no nativo de Lenguas extranjeras, con algunos de los métodos necesari
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