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 surgery Keywords: Non-surgical treatment of anal fissure, fissure in ano, sphicterotomy,botulinum toxin in anal fissures, glyceryl trinitrate. Chemical sphincteratomy, pharmacological sphincteratomy.
A general velocity profile for a laminar flow over a flat plate with zero incidence is obtained by employing a new boundary condition to the other available boundary conditions. The general velocity profile is mathematically simple and nearest to the exact solution. Also other related values, boundary layer thickness, displacement thickness, momentum thickness and coefficient of friction are nearest to the exact solution compared with other corresponding values for other researchers.
This study focuses on the impact of technology on creating a dystopian world as presented by the English playwright Caryl Churchill in her play A Number (2002). This dramatic work came as a reaction to the most crucial and valuable turning point in the scientific achievements of human engineering, namely, the cloning of the sheep called Dolly. Therefore, A Number is a play that presents an analytical stage for imagining the biotechnological and scientific future. This dramatic vignette captures the playwright’s fears towards the abnormal progress of technology and science and how far such technological progress affects human relationships and identity. It also portrays how technological progress results in the feeling of a lack of
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The substantial key to initiate an explicit statistical formula for a physically specified continua is to consider a derivative expression, in order to identify the definitive configuration of the continua itself. Moreover, this statistical formula is to reflect the whole distribution of the formula of which the considered continua is the most likely to be dependent. However, a somewhat mathematically and physically tedious path to arrive at the required statistical formula is needed. The procedure in the present research is to establish, modify, and implement an optimized amalgamation between Airy stress function for elastically-deformed media and the multi-canonical joint probability density functions for multivariate distribution complet
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The subject of this study is one of the most interactive media networks, which is the Instagram.The study uses a descriptive approach and focuses on how Instagram turns from a media tool to a marketing tool. The study problematic consists of this question: How Instagram turns to a marketing tool, and what are the advantages and the disadvantages for that?This study highlights the definition of Instagram, the creation of it and its improvement, the Instagram in Bahrain, the Instagram uses, the Instagram as a marketing tool, and the advantages and disadvantages of using Instagram for marketing.The study confirms that Instagram is a new media network, and focuses on how it develops on later stages and mentions the increase of the percentage
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This paper is concerned with introducing and studying the new approximation operators based on a finite family of d. g. 'swhich are the core concept in this paper. In addition, we study generalization of some Pawlak's concepts and we offer generalize the definition of accuracy measure of approximations by using a finite family of d. g. 's.
A general velocity profile for a laminar flow over a flat plate with zero incidence is obtained by employing a new boundary condition to the other available boundary conditions. The general velocity profile is mathematically simple and nearest to the exact solution. Also other related values, boundary layer thickness, displacement thickness, momentum thickness and coefficient of friction are nearest to the exact solution compared with other corresponding values for other researchers.
Background: Secretory Immunoglobulin A (SIgA) is a subclass of Immunoglobulin A (IgA), It is an antibody that plays an important role in mucosal immunity. It is the main immunoglobulin found in mucous secretions from mammary glands, tear glands and salivary glands, every pathologic process in the body involves the immune system, and periodontal inflammation is one of them and is not an exception. Material and methods: this study was consisted of 60 healthy male participants of an age ranged between (35-50) years old ; 25 of them with generalized moderate chronic periodontists(Clinical Attachment Loss equal to 3-4mm at ≥ 30% of the sites; 20 participants with plaque induced gingivitis and 15 participants had clinically healthy pe
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The air flow pattern in a co-current pilot plant spray dryer fitted with a rotary disk atomizer was determined experimentally and modelled numerically using Computational Fluid Dynamics (CFD) (ANSYS Fluent ) software. The CFD simulation used a three dimensions system, Reynolds-Average Navier-Stokes equations (RANS), closed via the RNG k −ε turbulence model. Measurements were carried out at a rotation of the atomizer (3000 rpm) and when there is no rotation using a drying air at 25 oC and air velocity at the inlet of 5 m/s without swirl. The air flow pattern was predicted experimentally using cotton tufts and digital anemometer. The CFD simulation predicted a downward central flowing air core surrounded by a slow
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