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 present paper sheds light on irony as one of the most important and most common linguistic phenomena in modern linguistics, in general ,and in discourse in particular, whether it is (political, literary, journalistic, etc.). When irony is used correctly or positively, it paves the way for the speaker to gain the approval of other parties participating in the dialogue and dissolve barriers between them. It is a simple multi-functional linguistic style and an expression of one’s meaning by using language that normally signifies the opposite according to the context and the situation. Therefore, it is necessary to study its characteristics, define its functions and traces the extent of
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в статье рассматриваются проблемы преподавания русской литературы в иракской аудитории.. Использование литературы в преподавании иностранного языка, как правило, имеет две цели. Первая-чисто лингвистическая .. Вторая цель, однако, ассоциируется больше с экстралингвистикой и представляет собой ознакомление студентов с различными аспектами русской жизни, культуры,
... Show MoreThroughout this paper R represents a commutative ring with identity and all R-modules M are unitary left R-modules. In this work we introduce the notion of S-maximal submodules as a generalization of the class of maximal submodules, where a proper submodule N of an R-module M is called S-maximal, if whenever W is a semi essential submodule of M with N ? W ? M, implies that W = M. Various properties of an S-maximal submodule are considered, and we investigate some relationships between S-maximal submodules and some others related concepts such as almost maximal submodules and semimaximal submodules. Also, we study the behavior of S-maximal submodules in the class of multiplication modules. Farther more we give S-Jacobson radical of ri
... Show MoreA confluence of forces has brought journalism and journalism education to a precipice. The rise of fascism, the advance of digital technology, and the erosion of the economic foundation of news media are disrupting journalism and mass communication (JMC) around the world. Combined with the increasingly globalized nature of journalism and media, these forces are posing extraordinary challenges to and opportunities for journalism and media education. This essay outlines 10 core principles to guide and reinvigorate international JMC education. We offer a concluding principle for JMC education as a foundation for the general education of college students.
The nucleon momentum distributions (NMD) and elastic electron scattering form factors of the ground state for some 1f-2p-shell nuclei, such as 58Ni, 60Ni, 62Ni, and 64Ni
isotopes have been calculated in the framework of the coherent fluctuation model (CFM) and expressed in terms of the weight function lf(x)l2 . The weight function (fluctuation function) has been related to the nucleon density distribution (NDD) of the nuclei and determined from the theory and experiment. The NDD is derived from a simple method based on the use of the single particle wave functions of the harmonic oscillator potential and the occupation numbers of the states. The feature of the l
The study aims to integrate the visually impaired people into the art connoisseur community through producing special print artworks to enable the visually impaired people to use their other senses to feel artworks by using artistic printing techniques through adding some prominent materials to the printing colors or making an impact that visually impaired people can perceive using their other senses. This study also aims to set up art exhibitions that display tangible works that can enable visually impaired people to feel artwork and understand its elements to enable them to feel it through other senses.
The study follows the experimental method, through using artistic printing techniques, which allow printing with prominent textur
There are many methods of searching large amount of data to find one particular piece of information. Such as find name of person in record of mobile. Certain methods of organizing data make the search process more efficient the objective of these methods is to find the element with least cost (least time). Binary search algorithm is faster than sequential and other commonly used search algorithms. This research develops binary search algorithm by using new structure called Triple, structure in this structure data are represented as triple. It consists of three locations (1-Top, 2-Left, and 3-Right) Binary search algorithm divide the search interval in half, this process makes the maximum number of comparisons (Average case com
... Show MoreIraq depends mainly on Tigris and Euphrates Rivers to provide high percentage of agricultural water use for thousands years. At last years, Iraq is suffering from shortage in water resources due to global climate changes and unfair water politics of the neighboring countries, which affected the future of agriculture plans for irrigation, added to that the lack of developed systems of water management in the irrigation projects and improper allocation of irrigation water, which reduces water use efficiency and lead to losing irrigation water and decreasing in agricultural yield. This study aims at studying the usability of irrigation and leaching scheduling within the irrigating projects and putting a complete annual or seasonal irrigatio
... Show MoreIt is a common Knowledge that adverbs in Turkish languages can modify verbs, adjectives, nouns or other adverbs. Moreover, adverbs can determine the meanings of nouns and verbs in a sentence as far as time, place, manner, quantity and interrogative are concerned. The present study debates adverbs’ functions in Namiq Kamal’s play Vatan yahut Silistre.
The study sheds light on the author’s use of the adverbs to describe the required theatrical actions of the play and to convey his reflections and thoughts easily to the auidence. One of the main hindrances encountered in conducting the study is the shortage of the upto date academic resources necessary for
... Show MoreThe main purpose of this work is to introduce some types of fuzzy convergence sequences of operators defined on a standard fuzzy normed space (SFN-spaces) and investigate some properties and relationships between these concepts. Firstly, the definition of weak fuzzy convergence sequence in terms of fuzzy bounded linear functional is given. Then the notions of weakly and strongly fuzzy convergence sequences of operators are introduced and essential theorems related to these concepts are proved. In particular, if ( ) is a strongly fuzzy convergent sequence with a limit where linear operator from complete standard fuzzy normed space into a standard fuzzy normed space then belongs to the set of all fuzzy bounded linear operators