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.
There are obstacles to high levels of hypertension awareness that are embedded in gender, income and lifestyle habits which need to be addressed leading to high levels of undiagnosed and uncontrolled hypertension. This study aimed to explore the various factors which affect hypertension awareness among a hypertensive population in a tertiary care hospital.
A quantitative study was conducted among hypertensive patients at a tertiary care hospital in Selangor, Malaysia. A validated and translated questionnaire was utilised as a data collection tool. Descriptive and inferential statistical analysis was done using SPSS version 25.
A thousand participants (female n=621, male n= 379) were recruited, and their
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This study aims to know how and what is the media processing presented by the television talk shows for the religious extremism topics in terms of topics, hosted personalities, and ways to address this global phenomenon.
The study is based on descriptive research, and the researcher used the analytical-survey method, analyzing the episodes of (Awkar Al Dhalam) T.V Show which was presented on Al-Iraqiya News Channel, and (Islam Hur) T.V Show which was presented on Al-Hurra in 2019 with 25 episodes from each Show, The sample and research community was chosen with the intent to cover the research problem and its
The study reached several conclusions, including:
- The various dialogs in the episo
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Receipt date:2/17/2021 acceptance date:3/16/2021 Publishing date:12/31/2021
This work is licensed under a Creative Commons Attribution 4.0 International License.
Objective: This paper investigates the contradictions in the decision-making process of the United States, which historically proven to be successful policies in the short term, but in the long term proven to be wanting and failure. Methodology: The paper uses descriptive, historical, comparative method. A
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In this paper the variable structure control theory is utilized to derive a discontinuous controller to the magnetic levitation system. The magnetic levitation system model is considered uncertain, which subjected to the uncertainty in system parameters, also it is open-loop unstable and strongly nonlinear. The proposed variable structure control to magnetic levitation system is proved, and the area of attraction is determined. Additionally, the chattering, which induced due to the discontinuity in control law, is attenuated by using a non-smooth approximate. With this approximation the resulted controller is a continuous variable structure controller with a determined steady state error according to the selected control
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The efforts in designing and developing lightweight cryptography (LWC) started a decade ago. Many scholarly studies in literature report the enhancement of conventional cryptographic algorithms and the development of new algorithms. This significant number of studies resulted in the rise of many review studies on LWC in IoT. Due to the vast number of review studies on LWC in IoT, it is not known what the studies cover and how extensive the review studies are. Therefore, this article aimed to bridge the gap in the review studies by conducting a systematic scoping study. It analyzed the existing review articles on LWC in IoT to discover the extensiveness of the reviews and the topics covered. The results of the study suggested that many re
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Abstract
In this paper, fatigue damage accumulation were studied using many methods i.e.Corton-Dalon (CD),Corton-Dalon-Marsh(CDM), new non-linear model and experimental method. The prediction of fatigue lifetimes based on the two classical methods, Corton-Dalon (CD)andCorton-Dalon-Marsh (CDM), are uneconomic and non-conservative respectively. However satisfactory predictions were obtained by applying the proposed non-linear model (present model) for medium carbon steel compared with experimental work. Many shortcomings of the two classical methods are related to their inability to take into account the surface treatment effect as shot peening. It is clear that the new model shows that a much better and cons
... Show MoreAdvertisement on smart phone shopping apps are a new way of driving users to satisfy their needs and influence their purchasing decisions, In this way, the research could be aimed to know The role of the relationship between the motivations for audience exposure to shopping apps advertisement and purchasing decisions, In order to achieve the objectives of the research, the researcher adopted the survey method and used the questionnaire and the scale to collect data and information, The researcher chose the "random sample multi stages", The sample size was (475) respondents from Baghdad city center (18 years and above) women and men.
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In "historical" fiction, characters that never really existed, give expression to the impact of historical events on the people who really did live through them. The result is not history, as an accurate record of actual events, but fiction in which an earlier age is rendered through the personal joys and sufferings of characters. This paper
aims at investigating the historical realities presented in Dickens’s A Tale of Two Cities.