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 category of those who agree with the phrase: The Environment and Life Program warns me of the environmental damages resulting from the issue of using black oil in electrical generators in residential neighborhoods came first, with a high rate of 81.4%. With the environment, the public always turns to the public broadcasting service and its programs to provide knowledge so that it can avoid it. Thus, the respondents' attitude towards this issue was positive.
In this paper, Response Surface Method (RSM) is utilized to carry out an investigation of the impact of input parameters: electrode type (E.T.) [Gr, Cu and CuW], pulse duration of current (Ip), pulse duration on time (Ton), and pulse duration off time (Toff) on the surface finish in EDM operation. To approximate and concentrate the suggested second- order regression model is generally accepted for Surface Roughness Ra, a Central Composite Design (CCD) is utilized for evaluating the model constant coefficients of the input parameters on Surface Roughness (Ra). Examinations were performed on AISI D2 tool steel. The important coefficients are gotten by achieving successfully an Analysis of V
... Show MoreBackground/objectives: To study the motion equation under all perturbations effect for Low Earth Orbit (LEO) satellite. Predicting a satellite’s orbit is an important part of mission exploration. Methodology: Using 4th order Runge–Kutta’s method this equation was integrated numerically. In this study, the accurate perturbed value of orbital elements was calculated by using sub-steps number m during one revolution, also different step numbers nnn during 400 revolutions. The predication algorithm was applied and orbital elements changing were analyzed. The satellite in LEO influences by drag more than other perturbations regardless nnn through semi-major axis and eccentricity reducing. Findings and novelty/improvement: The results demo
... Show MoreOmentin (or intelectin) is a main visceral fat secretory adipokine. There is a growing interest to link omentin, obesity and co-morbidity factors. The aim of the present study is to evaluate serum omentin and its association to insulin resistance biomarkers, lipid profile and atherogenic indies. This cross – sectional study was conducted in Obesity Research and Therapy Unit-Alkindy College of Medicine by recruiting (115) individuals; 49 males /66 females. Subjects between (20 to 60) years of age were selected and classified into two groups according to their Body mass index (BMI). Group1 involved healthy lean volunteers (25 male/ 36 female; BMI 18.5 - 24.9). Group2 involved obese subjects; (24 male / 36 female with BMI ≥ 30). The s
... Show MoreThe most frequently diagnosed condition in women at the age of reproduction is the polycystic ovarian syndrome (PCOS).it could be related to a complex endocrine condition, due to its heterogeneity and uncertainty about its etiology, as the clinical highlights of PCOS incorporate those related to reproductive signs such as decreased frequency of ovulation, irregular menstrual cycles, decreased fertility. Carnitine plays a substantial role in weight loss, glucose tolerance, insulin function and fatty acid metabolism. Thus carnitine plays a crucial role in controlling obesity, insulin resistance, oxidative stress that are associated with PCOS .While, AGEs are a diverse group of reactive molecules that are formed end
... Show MoreThe study aimed to reveal the level of knowledge and tendencies of high- study students specializing in curriculum and teaching methods at King Khalid University towards harmonious strategies with brain-based learning (BBL). And Then, putting a proposed concept to develop knowledge and tendencies of high-study students specializing in curriculum and teaching methods at King Khalid University towards harmonious strategies with Brain-based learning (BBL). For achieving this goal, a cognitive test and a scale of tendency were prepared to apply harmonious strategies with brain-based learning. The descriptive approach was used because it suits the goals of the study. The study sample consisted of (70) male and female students of postgraduate
... Show MoreInferential methods of statistical distributions have reached a high level of interest in recent years. However, in real life, data can follow more than one distribution, and then mixture models must be fitted to such data. One of which is a finite mixture of Rayleigh distribution that is widely used in modelling lifetime data in many fields, such as medicine, agriculture and engineering. In this paper, we proposed a new Bayesian frameworks by assuming conjugate priors for the square of the component parameters. We used this prior distribution in the classical Bayesian, Metropolis-hasting (MH) and Gibbs sampler methods. The performance of these techniques were assessed by conducting data which was generated from two and three-component mixt
... Show MoreObjective: To assess the effect of six-minute walk test on health-related quality of life in patients undergone coronary artery bypass graft surgery at Iraqi center for heart diseases. Material: This descriptive study was conducted from 8th August, 2022 to 10th January, 2023. A non-probability purposive sample of 50 patients undergoing coronary artery bypass graft surgery at Iraqi center for heart diseases was included in the study. A questionnaire composed of three parts; sociodemographic and clinical data, six-minute walk test (6MWT) and health-related quality of life (HRQoL) were used. SPSS version 26 was utilized to analyze data. Results: Patient’s performance showed highly significant statistical differences at p<0.05 betw
... Show MoreRecycling process presents a sustainable pavement by using the old materials that could be milled, mixed with virgin materials and recycling agents to produce recycled mixtures. The objective of this study is to evaluate the impact of water on recycled asphalt concrete mixtures, and the effect of the inclusion of old materials into recycled mixtures on the resistance of water damage. A total of 54 Marshall Specimens and 54 compressive strength specimens of (virgin, recycled, and aged asphalt concrete mixtures) had been prepared, and subjected to Tensile Strength Ratio test, and Index of Retained Strength test. Four types of recycling agents (used oil, oil + crumb rubber, soft grade asphalt cement, and asphalt cement + Su
... Show MoreThe path and its nodal purposes
Abstract
This study has come to indicate the doctrinal purposes of faith in this path، It was composed of an introduction and four demands، as follows:
The first requirement: the intentions of distinguishing between the ranks of people according to divine justice، as those who pass by him are different. Some of them are safe by his work، surviving from the fire، and some of them are not peace، he falls into the fire of Hell، and all of them are different in their ranks in a manner consistent with the justice of God Almighty and the works they have given themselves.
The second requirement: the purposes of divine mercy in honoring the Prophet and his nation on the path and embodying their