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 oyster ??????? (planned) (Pallas) of lesions that have entered Iraq recently became spyware severe damage in more than a station from power plants in Iraq, including the power plant in Mussayab Vamahar accumulates in pipes cooling and disrupts their work Vtafrtf heat systems cooling and thereby determiningefficiency and lead to added cost many cleaning or replacement of damaged parts
Let be a ring. Given two positive integers and , an module is said to be -presented, if there is an exact sequence of -modules with is -generated. A submodule of a right -module is said to be -pure in , if for every -Presented left -module the canonical map is a monomorphism. An -module has the -pure intersection property if the intersection of any two -pure submodules is again -pure. In this paper we give some characterizations, theorems and properties of modules with the -pure intersection property.
When scheduling rules become incapable to tackle the presence of a variety of unexpected disruptions frequently occurred in manufacturing systems, it is necessary to develop a reactive schedule which can absorb the effects of such disruptions. Such responding requires efficient strategies, policies, and methods to controlling production & maintaining high shop performance. This can be achieved through rescheduling task which defined as an essential operating function to efficiently tackle and response to uncertainties and unexpected events. The framework proposed in this study consists of rescheduling approaches, strategies, policies, and techniques, which represents a guideline for most manufacturing companies operatin
... Show MoreThe present study aims at analyzing the polysemy of the English preposition in from the cognitive linguistic (CL) point of view using Evans' and Tyler's approach (2003). The perplexity faced by Iraqi second language learners (L2) due to the multi-usages of this preposition has motivated the researcher to conduct this study. Seventy-six second year university students participated in this experimental study. The data of the pre-test and post-test were analyzed by SPSS statistical editor. The results have shown the following: First, a progress of more than (0.05≤) has been detected as far as students' understanding of the multiple usages of the preposition in is concerned. Second, the results of the questionnaire have s
... Show MoreThe sensitive and important data are increased in the last decades rapidly, since the tremendous updating of networking infrastructure and communications. to secure this data becomes necessary with increasing volume of it, to satisfy securing for data, using different cipher techniques and methods to ensure goals of security that are integrity, confidentiality, and availability. This paper presented a proposed hybrid text cryptography method to encrypt a sensitive data by using different encryption algorithms such as: Caesar, Vigenère, Affine, and multiplicative. Using this hybrid text cryptography method aims to make the encryption process more secure and effective. The hybrid text cryptography method depends on circular queue. Using circ
... Show MoreThe current research is concerned with a pragmatic study of attack and defense acts that are used by President Donald Trump in the American Presidential Debate in 2020. Attack is an attempt to harm or defeat someone, and it is a bold message that the speaker or attacker does not like or disagree with the other antagonist. On the contrary, defense means a person responds to an attack of his or her opponent. After an attack, the politician either negates or fact-checks claims made by his opponents or tries to set the record straight. By the end of the study, it is expected to answer the following questions: What are the most frequent strategies of attack and defense that utilized by President Trump to formulate his speech? What are the reason
... Show MoreIn this research, we introduce and study the concept of fibrewise bitopological spaces. We generalize some fundamental results from fibrewise topology into fibrewise bitopological space. We also introduce the concepts of fibrewise closed bitopological spaces,(resp., open, locally sliceable and locally sectionable). We state and prove several propositions concerning with these concepts. On the other hand, we extend separation axioms of ordinary bitopology into fibrewise setting. The separation axioms we extend are called fibrewise pairwise T_0 spaces, fibrewise pairwise T_1 spaces, fibrewise pairwise R_0 spaces, fibrewise pairwise Hausdorff spaces, fibrewise pairwise functionally Hausdorff spaces, fibrewise pairwise regular spaces, fibrewise
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