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 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
... Show MoreBackground: Understanding Middle Eastern Culture in literature is essential for engaging readers worldwide. A society's culture can be reflected through literature. To this end, this study aims to identify the stylistic patterns that reflect Middle Eastern culture in the selected data and to examine how the multilevel approach of this study helps to locate these patterns. Ibtisam Barakat’s Tasting the Sky: A Palestinian Childhood (2007) memoir is selected as the data of the study. Methodology: the cognitive corpus stylistic approach is applied to identify language patterns and stylistic features in the selected data. The multilevel method targets the language patterns that reflect the culture of the Middle East in th
... Show MoreNathaniel 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
... Show MoreIn 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
... Show MoreBackground: 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
... Show MoreTransportation is one of the aspects that enable us to achieve sustainability on a university campus, by taking environmental, social, and economic requirements. Walking is a green mode that can be essential to promoting sustainable transport. This study aims to evaluate the ability of campus physical development planning at Diyala University in creating sustainable transport on campus by determining the problems that exist. The research problem was identified in the absence of a comprehensive view of the importance of greenway network connectivity in the sustainability of the campus and the most important barriers that prevent it from being achieved and the incentives to be activated. The methodology used in this study was the quantitative
... Show MoreAmongst 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 MoreA mathematical eco-epidemiological model consisting of harvested prey–predator system involving fear and disease in the prey population is formulated and studied. The prey population is supposed to be separated into two groups: susceptible and infected. The susceptible prey grows logistically, whereas the infected prey cannot reproduce and instead competes for the environment’s carrying capacity. Furthermore, the disease is transferred through contact from infected to susceptible individuals, and there is no inherited transmission. The existence, positivity, and boundedness of the model’s solution are discussed. The local stability analysis is carried out. The persistence requirements are established. The global behavior of th
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