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.
Novel has recently received the attention of readers and writers greatly, because of the role they play, and this indicates an important rule, which is whenever there is an art or creativity, there must be a respective criticism, and this criticism is certainly not less important than the author. So there are critics who have a prestigious literary position in the follow-up story development, and trying to describe the transformation of its elements. One of these critics is professor Fadhel Thamer, and who wants to approach one of the elements of the novel exploring, must stop on the visions of this critic about it , and that’s why we take the (character) element following the most important opinions of this critic about
... Show MoreWe propose a new method for detecting the abnormality in cerebral tissues present within Magnetic Resonance Images (MRI). Present classifier is comprised of cerebral tissue extraction, image division into angular and distance span vectors, acquirement of four features for each portion and classification to ascertain the abnormality location. The threshold value and region of interest are discerned using operator input and Otsu algorithm. Novel brain slices image division is introduced via angular and distance span vectors of sizes 24˚ with 15 pixels. Rotation invariance of the angular span vector is determined. An automatic image categorization into normal and abnormal brain tissues is performed using Support Vector Machine (SVM). St
... Show MoreThis article proposes a new strategy based on a hybrid method that combines the gravitational search algorithm (GSA) with the bat algorithm (BAT) to solve a single-objective optimization problem. It first runs GSA, followed by BAT as the second step. The proposed approach relies on a parameter between 0 and 1 to address the problem of falling into local research because the lack of a local search mechanism increases intensity search, whereas diversity remains high and easily falls into the local optimum. The improvement is equivalent to the speed of the original BAT. Access speed is increased for the best solution. All solutions in the population are updated before the end of the operation of the proposed algorithm. The diversification f
... Show MoreCrop production is reduced by insufficient and/or excess soil water, which can significantly decrease plant growth and development. Therefore, conservation management practices such as cover crops (CCs) are used to optimize soil water dynamics, since CCs can conserve soil water. The objective of this study was to determine the effects of CCs on soil water dynamics on a corn (
Metoclopramide HCl (MTB) is a potent antiemetic drug used for the treatment of nausea and vomiting. Many trials were made to prepare a satisfactory MTB orodispersible tablet using direct compression method.Various super disintegrants were used in this study which are croscarmellose sodium (CCS), sodium starch glycolate (SSG) and crospovidone (CP). The latter was the best in terms of showing the fastest disintegration time in the mouth.Among the different diluents utilized, it was found that a combination of microcrystalline cellulose PH101 (MCC 101), mannitol, dicalcium phosphate dihydrate (DPD) and Glycine was the best in preparing MTB orodispersible tablet with fastest disintegration time in the mouth.The physical parameters of the pre
... Show MoreThe performance quality and searching speed of Block Matching (BM) algorithm are affected by shapes and sizes of the search patterns used in the algorithm. In this paper, Kite Cross Hexagonal Search (KCHS) is proposed. This algorithm uses different search patterns (kite, cross, and hexagonal) to search for the best Motion Vector (MV). In first step, KCHS uses cross search pattern. In second step, it uses one of kite search patterns (up, down, left, or right depending on the first step). In subsequent steps, it uses large/small Hexagonal Search (HS) patterns. This new algorithm is compared with several known fast block matching algorithms. Comparisons are based on search points and Peak Signal to Noise Ratio (PSNR). According to resul
... Show MoreIn this paper a system is designed on an FPGA using a Nios II soft-core processor, to detect the colour of a specific surface and moving a robot arm accordingly. The surface being detected is bounded by a starting mark and an ending mark, to define the region of interest. The surface is also divided into sections as rows and columns and each section can have any colour. Such a system has so many uses like for example warehouses or even in stores where their storing areas can be divided to sections and each section is coloured and a robot arm collects objects from these sections according to the section’s colour also the robot arm can organize objects in sections according to the section’s colour.
Language is an important means through which one can construct one's social world. Accordingly, the way we view ourselves and the world is basically formed by language use whereby identities, relations, and values are constructed and maintained. Most discourse analysts consider narrative not only the locus of construction and enactment of identity, but also a distinguished genre for its analysis.The present study is concerned with how identity can poetically be informed, hence exploring the way black poets use language when reflecting their identity and culture. The poem, right on: white america by the black American poetess Sonia Sanchez, is chosen to be analyzed based on Simpson's stylistic model (2004). In this model, the ana
... Show MoreThis paper includes a comparison between denoising techniques by using statistical approach, principal component analysis with local pixel grouping (PCA-LPG), this procedure is iterated second time to further improve the denoising performance, and other enhancement filters were used. Like adaptive Wiener low pass-filter to a grayscale image that has been degraded by constant power additive noise, based on statistics estimated from a local neighborhood of each pixel. Performs Median filter of the input noisy image, each output pixel contains the Median value in the M-by-N neighborhood around the corresponding pixel in the input image, Gaussian low pass-filter and Order-statistic filter also be used.
Experimental results shows LPG-
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