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.
Belgium is one of the countries that headed towards federalism through a peaceful transition, and over a few decades the country has witnessed deep transformations in its institutions, from a unified and central state in the early nineteenth century to a federal union, regional operations began since 1970 up and constitutionally established its diversity Linguistic and regional, the so -called "state reforms" have been implemented, which led to the emergence of political repercussions. The country has suffered about two decades ago, which caused many national governments that are considered to be among the Luxor in the modern political history of Belgium, However, institutional reforms to achieve the stability of the political system began,
... Show MoreVariable-Length Subnet Masks (VLSM), often referred to as "subnetting a subnet", is used to maximize addressing efficiency. The network administrator is able to use a long mask on networks with few hosts, and a short mask on subnets with many hosts. This addressing scheme allows growth and does not involve wasting addresses. VLSM gives a way of subnetting a network with minimal loses of IP addresses for a specific range. Unfortunately, the network administrator has to perform several mathematical steps (or use charts) to get the required results from VLSM. In this paper, a simple graph simulator is proposed (using Visual Basic 6.0 Language) to perform all the required mathematical steps and to display the obtained required information (the
... Show MoreThis study investigated the cubic intuitionistic fuzzy set of TM-algebra as a generalization of the cubic set. First, a cubic intuitionistic ideal and a cubic intuitionistic T-ideal are defined, followed by a discussion of their properties. Furthermore, the level set of a cubic intuitionistic TM-algebra is defined, and the relationship between a cubic intuitionistic level set and the cubic intuitionistic T-ideal is established. A novel definition of a cubic intuitionistic set under homomorphism is proposed, and several significant results are demonstrated.
Several Intrusion Detection Systems (IDS) have been proposed in the current decade. Most datasets which associate with intrusion detection dataset suffer from an imbalance class problem. This problem limits the performance of classifier for minority classes. This paper has presented a novel class imbalance processing technology for large scale multiclass dataset, referred to as BMCD. Our algorithm is based on adapting the Synthetic Minority Over-Sampling Technique (SMOTE) with multiclass dataset to improve the detection rate of minority classes while ensuring efficiency. In this work we have been combined five individual CICIDS2017 dataset to create one multiclass dataset which contains several types of attacks. To prove the eff
... Show MoreIn this paper a nonlinear adaptive control method is presented for a pH process, which is difficult to control due to the nonlinear and uncertainties. A theoretical and experimental investigation was conducted of the dynamic behavior of neutralization process in a continuous stirred tank reactor (CSTR). The process control was implemented using different control strategies, velocity form of PI control and nonlinear adaptive control. Through simulation studies it has been shown that the estimated parameters are in good agreement with the actual values and that the proposed adaptive controller has excellent tracking and regulation performance.
This study sought to determine malformation caused by Ochratoxin-A (OTA) on mouse embryos. Twenty adult female white Swiss mice (mus msculus) were divided into four groups, with five females per group, and with one male placed with two females in a cage. Avaginal plug was observed in the early morning and the day of mating was considered as day of pregnancy followed by the first day of pregnancy. Three sub lethal concentrations of OTA were applied to the respective groups (other than the control), 1mg/kg, 2mg/kg and 4mg/kg. The animals were given 0.1 ml per 10 gm body weight per concentration of OTA once a day during days 7-14 of pregnancy. The control group animals were given distilled water. The pregnant mice were dissected, and the embry
... Show MoreOnline communication on social networks has become a never-given-up way of expressing and sharing views and opinions within the realm of all topics on earth, and that is that! A basis essential in this is the limits at which "freedom of expression" should not be trespassed so as not to fall into the expression of "hate speech". These two ends make a base in the UN regulations pertaining to human rights: One is free to express, but not to hate by expression. Hereunder, a Critical Discourse Analysis in terms of Fairclough's dialectical-relational approach (2001) is made of Facebook posts (being made by common people, and not of official nature) targeting Islam and Muslims. This is made so as to recognize these instances of "speech" a
... Show MoreThis paper aims at presenting a comparison between objective and subjective tests . This paper attemptsto shed light on these two aspects of tests and make do a compression by using suitable techniques for objective and subjective tests .
The paper compares between the two techniques used by the objective and subjective tests respectively, the time and efforts required by each type, the extent to which each type can be reliable, and the skills each type is suitable to measure.
The paper shows that objective tests, on the contrary of the subjective ones, encourages guess> Objective tests are used to test specific areas of langua
... Show More