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 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
... Show MoreWe used to think of grammar as the bones of the language and vocabulary as the flesh to be added given that language consisted largely of life generated chunks of lexis. This “skeleton image” has been proverbially used to refer to that central feature of lexis named collocation- an idea that for the first 15 years of language study and analysis gave a moment‟s thought to English classroom material and methodology.
The work of John Sinclair, Dave Willis, Ron Carter, Michael McCarthy, Michael Lewis, and many others have all contributed to the way teachers today approach the area of lexis and what it means in the teaching/learning process of the language. This also seems to have incorporated lexical ideas into the teaching mechanis
A new concrete rheometer is introduced including its innovation, actual design, working rules,
calibration, and reliability. A modified design of Tattersall two-point device is created. Some of
components are purchased from local and foreign markets, while other components and the
manufacturing process are locally fabricated. The matching viscosity method of determining the mixer
viscometer constants is demonstrated and followed to relate torque and rotational speed to yield stress
and viscosity (Bingham parameters). The calibration procedures and its calculation are explained.
Water is used as a Newtonian fluid, while; cement paste (cement + water) with w/c ratio equal to
(0.442) is used as a non-Newtonian fluid. Th
In recent years, Bitcoin has become the most widely used blockchain platform in business and finance. The goal of this work is to find a viable prediction model that incorporates and perhaps improves on a combination of available models. Among the techniques utilized in this paper are exponential smoothing, ARIMA, artificial neural networks (ANNs) models, and prediction combination models. The study's most obvious discovery is that artificial intelligence models improve the results of compound prediction models. The second key discovery was that a strong combination forecasting model that responds to the multiple fluctuations that occur in the bitcoin time series and Error improvement should be used. Based on the results, the prediction acc
... Show MoreIn this study, a brand-new graph definition known Associate graph of a ring R denote Ass(R) is present, where the graph’s vertices stand in for R’s elements s.t, any two vertices α and β merage by an edge if and only if α = rβ and β = sα. In this paper, we investigated some new property of Ass (R) are studied., the complement of Ass (R) is finally defined and a few of its characteristics are researched.