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 new human-based heuristic optimization method, named the Snooker-Based Optimization Algorithm (SBOA), is introduced in this study. The inspiration for this method is drawn from the traits of sales elites—those qualities every salesperson aspires to possess. Typically, salespersons strive to enhance their skills through autonomous learning or by seeking guidance from others. Furthermore, they engage in regular communication with customers to gain approval for their products or services. Building upon this concept, SBOA aims to find the optimal solution within a given search space, traversing all positions to obtain all possible values. To assesses the feasibility and effectiveness of SBOA in comparison to other algorithms, we conducte
... Show MoreThis research is a theoretical study that deals with the presentation of the literature of statistical analysis from the perspective of gender or what is called Engendering Statistics. The researcher relied on a number of UN reports as well as some foreign sources to conduct the current study. Gender statistics are defined as statistics that reflect the differences and inequality of the status of women and men overall domains of life, and their importance stems from the fact that it is an important tool in promoting equality as a necessity for the process of sustainable development and the formulation of national and effective development policies and programs. The empowerment of women and the achievement of equality between men and wome
... Show MoreMigration today is a global problem and is an extraordinary social phenomenon that affects countries around the world. Globalization, demographic shifts, political persecution, wars, armed conflicts, natural and environmental disasters, lack of skills, employment and other reasons in many countries have accelerated global migration rates. It has been observed in recent years that there is a rapid feminization of all forms and stages of migration. Women now make up nearly half of the migrant population around the world, and it appears that women have their own motives for migration in addition to family reunification in escaping Gender discrimination, political violence, and social independence, economic motives and the desire for better opp
... Show MoreA new definition of a graph called Pure graph of a ring denote Pur(R) was presented , where the vertices of the graph represent the elements of R such that there is an edge between the two vertices ???? and ???? if and only if ????=???????? ???????? ????=????????, denoted by pur(R) . In this work we studied some new properties of pur(R) finally we defined the complement of pur(R) and studied some of it is properties
The concept of the order sum graph associated with a finite group based on the order of the group and order of group elements is introduced. Some of the properties and characteristics such as size, chromatic number, domination number, diameter, circumference, independence number, clique number, vertex connectivity, spectra, and Laplacian spectra of the order sum graph are determined. Characterizations of the order sum graph to be complete, perfect, etc. are also obtained.
An energy and exergy thermodynamic analysis using EES program was done for a domestic refrigerator working with R-134a using vapor compression refrigeration cycle. The analysis deals with the system component, i.e. compressor, condenser, evaporator and the expansion device. The analysis depends on the entropy generation minimization approach to improve the refrigerator performance by exploring the optimum design points. These design points were derived from three different theories governing the entropy generation minimization using exergy analyzing method. These theories were first applied to find the optimum balance between the hot inner condenser area and the cold inner evaporator area of the refrigerator and between
... Show MoreVarious methods are utilized providing complexity for cryptosystem with the aim to increase the security and avoiding hacker attack. Hybrid cryptosystem is one of these cryptosystems which is used two types of cryptosystems and has many applications in data transmitted. This research, proposed a novel method that used power exponent instead of using the prime number directly and also providing complexity of asymmetric cryptosystems. This method has been applied theoretically in two public systems RSA and EL-Gamal. Power RSA and Power EL-Gamal are modified asymmetric cryptosystems, in which the power number is kept by the sender and the receiver. Moreover, we use group theory to prove that these cryptosystems work properly. Our exten
... Show MoreSystems on Chips (SoCs) architecture complexity is result of integrating a large numbers of cores in a single chip. The approaches should address the systems particular challenges such as reliability, performance, and power constraints. Monitoring became a necessary part for testing, debugging and performance evaluations of SoCs at run time, as On-chip monitoring is employed to provide environmental information, such as temperature, voltage, and error data. Real-time system validation is done by exploiting the monitoring to determine the proper operation of a system within the designed parameters. The paper explains the common monitoring operations in SoCs, showing the functionality of thermal, voltage and soft error monitors. The different
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