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.
The software-defined network (SDN) is a new technology that separates the control plane from data plane for the network devices. One of the most significant issues in the video surveillance system is the link failure. When the path failure occurs, the monitoring center cannot receive the video from the cameras. In this paper, two methods are proposed to solve this problem. The first method uses the Dijkstra algorithm to re-find the path at the source node switch. The second method uses the Dijkstra algorithm to re-find the path at the ingress node switch (or failed link).
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Nathaniel Hawthorne (1804-1864) has been widely known for his special interest in the female characters. In many of his novels, he narrates the conditions, values, and the institutions that surround and control the life of women, leading them to be victims. In “Rappaccini’s Daughter” (1844), the heroine, Beatrice is created to be victimized by her loved ones (her father and lover). This paper focuses on the term “victim,” it shows its aspects through the development of Beatrice’s character. The paper also studies a female character in the male-dominated society, to show the cruelty done to her, and how she is considered to be a second rate person, who is unable to live normally, or at least to save herself from dea
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S Khalifa E, AR Jamal R, N Adil A, J Munqithe M…, 2009
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.
In this paper, a novel flow control strategy which is the inlet throttled pump was used to design an angular velocity control system for rotary actuator. Inlet throttled systems have good performance in addition to their high efficiency compared to traditional valve-controlled systems. The flow in the proposed system is adjusted by a valve that is positioned at the pump inlet with the purpose of reducing the energy loses across the valve. This regulated flow is used then to control the actuator angular velocity. The system was modeled and the open loop stability and performance were studied. In order to improve the system performance, proportional-integral-derivative (PID) and H-infinity controllers have been designed. The multiplicative un
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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.
Amongst the literary writers who used their art to direct the attention towards the issue of woman and her rights in a proper life is the English poet and novelist Thomas Hardy (1840-1928), who has been praised for his “openness to the feminine principle” 1 as Irving Howe put it. Hardy’s wide readings have changed his way of dealing with and thinking about so many critical issues which started to float on the surface of the English society during the mid and late of the 19th century. His readings for a number of writers, who seem of huge impact on his writings as he later admits that – “[his] pages show harmony of view with
... Show MoreThe 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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