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.
Contemporary life is racing against time in its temptations and variables, and it has become shaped and changed in an amazing way in its various aspects and fields. This was facilitated by intellectual and scientific communication between civilizations, and the rapid progression in successive inventions and discoveries in the fields of science and arts of knowledge. This contributed to a great economic and commercial renaissance. Then, these economic developments entered the world into a very strong competition, which forced producers to calculate all production costs, to reach the highest profits by reducing the price of the produced commodity on the one hand, and achieving quality in appearance (especially) on the other hand. Since the ma
... Show MoreThe ultimate goal of any sale contract is to maximize the combined returns of the parties, knowing that these returns are not realized (in long-term contracts) except in the final stages of the contract. Therefore, this requires the parties to the contract to leave some elements open, including the price, because the adoption of a fixed price and inflexible will not be appropriate to meet their desires when contracting, especially with ignorance of matters beyond their will and may affect the market conditions, and the possibility of modifying the fixed price through The elimination is very limited, especially when the parties to the contract are equally in terms of economic strength. Hence, in order to respond to market uncertainties, the
... Show MoreThis paper designed a fault tolerance for soft real time distributed system (FTRTDS). This system is designed to be independently on specific mechanisms and facilities of the underlying real time distributed system. It is designed to be distributed on all the computers in the distributed system and controlled by a central unit.
Besides gathering information about a target program spontaneously, it provides information about the target operating system and the target hardware in order to diagnose the fault before occurring, so it can handle the situation before it comes on. And it provides a distributed system with the reactive capability of reconfiguring and reinitializing after the occurrence of a failure.
Information security is a crucial factor when communicating sensitive information between two parties. Steganography is one of the most techniques used for this purpose. This paper aims to enhance the capacity and robustness of hiding information by compressing image data to a small size while maintaining high quality so that the secret information remains invisible and only the sender and recipient can recognize the transmission. Three techniques are employed to conceal color and gray images, the Wavelet Color Process Technique (WCPT), Wavelet Gray Process Technique (WGPT), and Hybrid Gray Process Technique (HGPT). A comparison between the first and second techniques according to quality metrics, Root-Mean-Square Error (RMSE), Compression-
... Show MoreKE Sharquie, AA Noaimi, WK Al-Janabi, Journal of Cosmetics, Dermatological Sciences and Applications, 2013
The world is currently challenging the serious effects of the pandemic of the Coronavirus disease (COVID-19) caused by severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2). Data on pediatric COVID are rare and scattered in the literature. In this article, we presented the updated knowledge on the pediatric COVID-19 from different aspects. We hope it will increase the awareness of the pediatricians and health care professionals on this pandemic.
Protein arginine methyltransferases (PRMTs) play important roles in transcription, splicing, DNA damage repair, RNA biology, and cellular metabolism. Thus, PRMTs have been attractive targets for various diseases. In this study, we reported the design and synthesis of a potent pan-inhibitor for PRMTs that tethers a thioadenosine and various substituted guanidino groups through a propyl linker. Compound II757 exhibits a half-maximal inhibition concentration (IC50) value of 5 to 555 nM for eight tested PRMTs, with the highest inhibition for PRMT4 (IC50 = 5 nM). The kinetic study demonstrated that II757 competitively binds at the SAM binding site of PRMT1. Notably, II757 is selective for PRMTs over a panel of other methyltransferases, w
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An excellent reputation earned by initiating and practicing sustainable business practices has additional benefits, of which are reducing environmental incidents and an improvement in operational efficiency as this has the potential to help firms improve on productivity and bring down operating costs. Taken further, with ever-increasing socially and environmentally-conscious investors and the public alike, this act of natural resources management could have a significant implication on market value and income of the practicing firms.
The above proposition has been supported by sustainable business practices literature that is continuously conversing and deliberating upon the impact of efficient resource d
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