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.
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<p><span>This research deals with the feasibility of a mobile robot to navigate and discover its location at unknown environments, and then constructing maps of these navigated environments for future usage. In this work, we proposed a modified Extended Kalman Filter- Simultaneous Localization and Mapping (EKF-SLAM) technique which was implemented for different unknown environments containing a different number of landmarks. Then, the detectable landmarks will play an important role in controlling the overall navigation process and EKF-SLAM technique’s performance. MATLAB simulation results of the EKF-SLAM technique come with better performance as compared with an odometry approach performance in terms of measuring the
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Ahmed ibn Imad ibn Yusuf al-Aqfhasi (808 AH / 1405 AD) is a small message that speaks about the Nile River in all its sides, despite its limited papers, but it is one of the manuscripts of the important geographical literature for its geographical, historical, religious and grammatical information. it was not limited to the information of the author alore, but taken from many sources below, which added to the importance of the fact that it has saved us the names of the sources that preceded him in mentioning this river with the names of its authors.The method of the Aqfhasi was characterized by scientific methodology in writing and clarity, with reference to some of the myths that people carried in their minds about the Nile River at tha
... Show MoreCharacterization is commonly known in stylistics to be the cognitive process in the readers' minds when comprehending a fictional character in a literary work .In one approach, it is assumed that characters are the outcome of the interaction between the words in the text on the one hand and the contents of our heads on the other. This paper is an attempt to understand how characterization is achieved by applying Culpeper’s (2001) model which seems to be to present a method of analysis that is more objective and more systematic in analyzing characters. Two characters are selected for discussion; Ralph and Jack from Golding’s (1954) Lord of the Flies. The novel talks about the corruption of human beings and the capacity of evil th
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In this research the a-As flims have been prepared by thermal evaporation with thickness 250 nm and rata of deposition (1.04nm/sec) as function to annealing temperature (373 and 373K), from XRD analysis we can see that the degree of crystalline increase with , and I-V characteristic for dark and illumination shows that forward bias current varieties approximately exponentially with voltage bias. Also we found that the quality factor and saturation current dependence on annealing temperatures.
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