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.
Abstract: The power and the size of the final spot of the laser beam reaching the target are very important requirements in most of the laser applications and fields such as medical, military, and scientific, so studying laser propagation in the atmosphere is a very important topic. The propagation of the laser beam through the atmosphere is subject to several attenuation processes that deplete the power and expand the beam. Through the simulation results of the free electron laser within the visible region of the electromagnetic spectrum (400-700nm), it was found that the attenuation increases with decreasing wavelength. Laser propagation in the presence of rain and snow leads to a very large loss of power compared to propagation i
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Water supply networks are marred by serious risks of imperceptible pipeline leakage, posing sustainability and performance threats. This article highlights the use of vibratory signal features to get around the drawbacks of traditional methods in a highly detailed framework for leak detection based on CatBoost. demonstrated excellent diagnostic performance and carried out a thorough test performance evaluation on five leakage configurations . The expected system achieved an accuracy of 98.1% (variance (well within x/3% of expected):, beating traditional competitors such as Random Forest (97.3%) and Support Vector Machine (93.8%). For example, the area under the receiver-operating characteristic curve was 0.995, in
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This research work aims to the determination of molybdenum (VI) ion via the formation of peroxy molybdenum compounds which has red-brown colour with absorbance wave length at 455nm for the system of ammonia solution-hydrogen peroxide-molybdenum (VI) using a completely newly developed microphotometer based on the ON-Line measurement. Variation of responses expressed in millivolt. A correlation coefficient of 0.9925 for the range of 2.5-150 ?g.ml-1 with percentage linearity of 98.50%. A detection limit of 0.25 ?g.ml-1 was obtained. All physical and chemical variable were optimized interferences of cation and anion were studied classical method of measurement were done and compared well with newly on-line measurements. Application for the use
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Arab translators have always paid great attention to the translation of the Persian literary genres, in particular, contemporary Iranian novels. They have always translated for the most prominent Iranian novelists such as Jalal Al Ahmad, Sadiq Hidayat, Mahmoud Dowlatabadi, Bozorg Alavi, Ismail Fasih, Houshang Golshiri, Gholam-Hossein Saedi, Simin Daneshvar, Sadiq Chubak, Samad Behrangi and others that have succeeded in perfectly picturing the Iranian society.
Within the perspectives of Arab translators and by using the descriptive - analytical approach, the present study provides an analytical study of the translation into Arabic some of the modern Persian novels. Moreove
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Need organizations today to move towards strategic thinking which means analyzing situations faced by particular challenges of change in the external environment, which makes it imperative for The Organization That to reconsider their strategies and orientations and operations, a so-called re-engineering to meet those challenges and pressures, to try to achieve improvement root in the installation of the organization and methodscompletion of its work towards achieving high levels of performance and that is reflected to achieve its objectives, and this is what aims to Current search to deal with implications characteristics of strategic thinking in the stages of application re-engineering business of the company General Industries
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field of modern and contemporary Yemeni history, accomplished at Ibn Rushd College of Education, University of Baghdad. It was determined according to a time frame in the years 1989, which is the date of completion of the first master’s thesis in the field of modern and contemporary Yemeni history, which deals with the subject of “Iraqi-Yemeni relations 1932- 1962”, and the year 2020, which is the year of completion of a master’s thesis on the position of Iraqi public opinion on the Egyptian military intervention in Yemen (1962-1970). The study determined the nature of these studies, whether they were in the form of master’s theses or doctoral dissertations, or research and studies published in issues of the refereed scien
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