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.
Allah legislated marriage and made it dwelling, fellowship and mercy between
the two couples, Prophet Moh'd (peace of Allah and blessing be upon him) ordered a
husband to look after his wife, treat her with full charity and make love with here
every kindly. On the other hand, he ordered a wife to obey her husband and respect
him deeply, nevertheless, some obstacles may sometimes be appeared within the life
of their marriage, this may be caused by either a husband or a wife. This problem is
called lifely disobedience (AL-Noshooz).
In the other words, this means that a wife begins to hate her husband, refuse his orders
and not obey him.
In brief, they hate each other which leads to some marks appear in their
m
(3)
(3)
The European Unit has never been affected by a serious phenomena as the phenomena of the advancing of the far right parties. Though these parties vary in their impact in their original countries, they agree on one important issue which is the deconstruction of the European unit and limiting its supernational powers. These increasing popular parties aim at more national independence in decision making away from the decisions taken by Brussels. Moreover, they criticize the financial and administrative corruption accompanied many of the rescuing procedures directed for example towards countries like Greece and Spain during the international economic crisis. This failure nourishes many of the negative feelings against the European unit which
... Show More
(3)
This work presents a simple method for determination of the neutron reflection coefficient (n) as a function of different neutron reflector materials.A laboratory neutron source (Am-Be) with activity of 16 ci is employed with a (BF3) neutron detector. Am-BeThree types of reflector materials are used as samples, the thickness of each sample is (5cm).It is found that( ?7) is: -For polyethlyene = 0.818
The convergence speed is the most important feature of Back-Propagation (BP) algorithm. A lot of improvements were proposed to this algorithm since its presentation, in order to speed up the convergence phase. In this paper, a new modified BP algorithm called Speeding up Back-Propagation Learning (SUBPL) algorithm is proposed and compared to the standard BP. Different data sets were implemented and experimented to verify the improvement in SUBPL.
This study deals with knowing the public relations activities of the Integrity Commission for the year 2007, knowing the contents of these activities, knowing the contents of the advertisements that it published, whether the contents of the advertisements were convincing, and whether press photographs were used in these advertisements, as well as whether symbols and slogans were used. What language and words were used to address the recipient? 1- What feelings do the contents of advertisements arouse? 2- Research objectives: This research aims to answer the following questions: What are the public relations activities carried out by the Integrity Commission? B: Are the contents of the advertisements published by the Authority convincing to
... Show MoreIn this research the a-As flims have been prepared by thermal evaporation with thickness 250 nm and rata of deposition r_d(1.04nm/sec) as function to annealing temperature (373 and 473K), from XRD analysis we can see that the degree of crystalline increase with T_a, and I-V characteristic for dark and illumination shows that forward bias current varieties approximately exponentially with voltage bias. Also we found that the quality factor and saturation current dependence on annealing temperatures.