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.
Pathology reports are necessary for specialists to make an appropriate diagnosis of diseases in general and blood diseases in particular. Therefore, specialists check blood cells and other blood details. Thus, to diagnose a disease, specialists must analyze the factors of the patient’s blood and medical history. Generally, doctors have tended to use intelligent agents to help them with CBC analysis. However, these agents need analytical tools to extract the parameters (CBC parameters) employed in the prediction of the development of life-threatening bacteremia and offer prognostic data. Therefore, this paper proposes an enhancement to the Rabin–Karp algorithm and then mixes it with the fuzzy ratio to make this algorithm suitable
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In this paper, we study the peristaltic transport of incompressible Bingham plastic fluid in a curved channel. The formulation of the problem is presented through, the regular perturbation technique for small values of is used to find the final expression of stream function. The numerical solution of pressure rise per wave length is obtained through numerical integration because its analytical solution is impossible. Also the trapping phenomenon is analyzed. The effect of the variation of the physical parameters of the problem are discussed and illustrated graphically.
The present paper is a qualitative descriptive study. It aims to examine the macro-cultural schemata addressing the concept of violence against women in Iraq from a cognitive linguistic point of view. To meet this objective, a number of Iraqi social caricatures have been selected from two popular and active Iraqi caricaturists, Odeh Al-Fahdawi and Nasser Ibrahim. The selection and the analysis of data have been achieved following the validity and reliability procedures and the ethical considerations. To meet this objective, Sharifian’s Model (2011) of Cultural Schemata has been adopted in data analysis. The study has concluded that the macro-cultural schemata regarding the concept of violence in the selected panels reveals that violenc
... Show MoreThe density functional B3LYP is used to investigate the effect of decorating the silver (Ag) atom on the sensing capability of an AlN nanotube (AlN-NT) in detecting thiophosgene (TP). There is a weak interaction between the pristine AlN-NT and TP with the sensing response (SR) of approximately 9.4. Decoration of the Ag atom into the structure of AlN-NT causes the adsorption energy of TP to decrease from − 6.2 to − 22.5 kcal/mol. Also, the corresponding SR increases significantly to 100.5. Moreover, the recovery time when TP is desorbed from the surface of the Ag-decorated AlN-NT (Ag@AlN-NT) is short, i.e., 24.9 s. The results show that Ag@AlN-NT can selectively detect TP among other gases, such as N2, O2, CO2, CO, and H2O.
This paper deals with the determination of stresses and deflections of clamped circular diaphragm strengthened by one or two ring-shaped concentric ribs, under uniform static and dynamic pressures. The simulation has been achieved by using the well-known engineering software finite element package MSC/NASTRAN.
As a design study, the effect of using a clamped ring, and the effect of using a ring-shaped rib on both surfaces of diaphragm instead of one, has been discussed in this work. To show the effectiveness of this study, results of this work have been compared with published data [1].
In the conclusion, the authors underline the validity of the&n
... Show MoreIn this work, a numerical study is performed to predict the solution of two – dimensional, steady and laminar mixed convection flow over a square cylinder placed symmetrically in a vertical parallel plate. A finite difference method is employed to solve the governing differential equations, continuity, momentum, and energy equation balances. The solution is obtained for stream function, vorticity and temperature as dependent variables by iterative technique known as successive over relaxation. The flow and temperature patterns are obtained for Reynolds number and Grashof number at (Re= -50,50,100,-100) (positive or negative value refers to aidding or opposing buoyancy , +1 assisting flow, -1 opposing flow) and (102 to 105) , respective
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