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.
Verbal Antonyms: A research in the relationship in meaning Between the words in Arabic language
In his post colonial novel, In the Skin of a lion, the Canadian/Sri Lankan writer,
Michael Ondaatje is so interested in the term "Post colonialism" because he wants to show
that the term doesn't only refer to a period of time that comes after colonialism. In other
words, post colonialism is not only referred to as a literal description of formerly colonial
societies. He deals with the termas a literary genre and an academic construct that describes
the global conditions of a man after a period of colonialism. He shows that post colonialism is
a theory that tries to examine and explore the different styles and faces of European authority
to control the colonized. Ondaatje's attempt through such term is to unmask Europ
In this research, the electrical characteristics of glow discharge plasma were studied. Glow discharge plasma generated in a home-made DC magnetron sputtering system, and a DC-power supply of high voltage as input to the discharge electrodes were both utilized. The distance between two electrodes is 4cm. The gas used to produce plasma is argon gas which flows inside the chamber at a rate of 40 sccm. The influence of work function for different target materials (gold, copper, and silver), - 5cm in diameter and around 1mm thickness - different working pressures, and different applied voltages on electrical characteristics (discharge current, discharge potential, and Paschen’s curve) were studied. The results showed that the discharge cur
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APDBN Rashid, Southern African Linguistics and Applied Language Studies, 2023
The main intention of this study was to investigate the development of a new optimization technique based on the differential evolution (DE) algorithm, for the purpose of linear frequency modulation radar signal de-noising. As the standard DE algorithm is a fixed length optimizer, it is not suitable for solving signal de-noising problems that call for variability. A modified crossover scheme called rand-length crossover was designed to fit the proposed variable-length DE, and the new DE algorithm is referred to as the random variable-length crossover differential evolution (rvlx-DE) algorithm. The measurement results demonstrate a highly efficient capability for target detection in terms of frequency response and peak forming that was isola
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This research deals with number of novels for Marguerit Doras , specially A Bridge Towards Basfic and The Lover . we specialize the first chapter for discussing a very important issue , which is the Maraguerit Doras novelist world in another word the most important themes . that we discuss and through that we tried to clerify the privacy the characters of Marguerit Doras in comparative with her own generation and in the second chapter we discussed the most important characteristics of the romantic hero spedially the characteristics of women in her novels.
Change the morphological characteristics with the change of the factors affecting it has been shown that the Tigris River has the characteristics of the morphology of the low values in terms of depth, width and perimeter wet and gradient which in turn affected the morphological and other characteristics in terms of the direction and pattern of runoff came through the study of 48 cross-section is taken of the Tigris River Year 2008 by section for each 1 km, it has been shown that the average width of the Tigris River does not exceed 221.1 meters and the average depth of 3.9 meters either wet ocean amounted to 268.9 meters and changed the cross-section area of the last section at a rate of 4594.3 square meters, and through the study turned
... Show MoreThe article describes a certain computation method of -arcs to construct the number of distinct -arcs in for . In this method, a new approach employed to compute the number of -arcs and the number of distinct arcs respectively. This approach is based on choosing the number of inequivalent classes } of -secant distributions that is the number of 4-secant, 3-secant, 2-secant, 1-secant and 0-secant in each process. The maximum size of -arc that has been constructed by this method is . The new method is a new tool to deal with the programming difficulties that sometimes may lead to programming problems represented by the increasing number of arcs. It is essential to reduce the established number of -arcs in each cons
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