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.
Today, the role of cloud computing in our day-to-day lives is very prominent. The cloud computing paradigm makes it possible to provide demand-based resources. Cloud computing has changed the way that organizations manage resources due to their robustness, low cost, and pervasive nature. Data security is usually realized using different methods such as encryption. However, the privacy of data is another important challenge that should be considered when transporting, storing, and analyzing data in the public cloud. In this paper, a new method is proposed to track malicious users who use their private key to decrypt data in a system, share it with others and cause system information leakage. Security policies are also considered to be int
... Show MoreAn experimental and numerical study has been carried out to investigate the forced convection heat transfer by clean or dusty air in a two dimensional annulus enclosure filled with porous media (glass beads) between two vertical concentric cylinders. The outer cylinder is of (82 mm) outside diameters and the inner cylinder of (27 mm) outside diameter. Under steady state condition; the inner cylinder surface is maintained at a high temperature by applying a uniform heat flux and the outer cylinder surface at an ambient temperature. The investigation covered values of input power of (6.3, 4.884, 4.04 and 3.26 W), Reynolds number values of (300, 700, 1000, 1500, and 2000) and dust ratio values (density number N) of (2, 4, 6 and 8). A comput
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The pressures of life have become a tangible phenomenon in all societies in varying degrees. This disparity determines several factors, including the nature of societies, the level of their urbanization, the intensity of interaction, the intensity of conflict, and the increasing rate of change in those societies. many people name The modern era in which we live the “era of pressures", where one of the most important of these changes is the “new Coronavirus 19-COVID”, which has spread widely throughout the world, as the pandemic, has affected all aspects of daily life, including the educational and academic process, academic activities have been suspended in universities, which caused sudden change
... Show MoreBackground: Osteoporosis is a skeletal defect manifested by a reduction of bone strength as a result of reduced bone mass to the extent that there is a higher risk of fracture even on minor trauma. Hysterectomy in a premenopausal woman is a well known cause of ovarian failure resulting in an increased risk of osteoporosis.
Objective : To clarify bisphosphonate's preventive effect on osteopenia and osteoporosis in premenopausal women after hysterectomy.
Type of the study: Cross –sectional study.
Method: 84 premenopausal females post hysterectomy aged between 40 – 50 years, were enrolled in this randomized controlled double blinded trail a
... Show MoreGiven that the Crimean and Congo hemorrhagic fever is one of the deadly viral diseases that occur seasonally due to the activity of the carrier “tick,” studying and developing a mathematical model simulating this illness are crucial. Due to the delay in the disease’s incubation time in the sick individual, the paper involved the development of a mathematical model modeling the transmission of the disease from the carrier to humans and its spread among them. The major objective is to comprehend the dynamics of illness transmission so that it may be controlled, as well as how time delay affects this. The discussion of every one of the solution’s qualitative attributes is included. According to the established basic reproductio
... Show MorePurpose: The main objective of this paper is, to determine the optimal no. of technicians’ men in a workshop crew of an Industrial System. Theoretical framework: The purpose of applying these tools is to explore their ability to reduce costs and improvements that can be obtained in the process of providing services to the end customer. Design/methodology/approach: The literature structure review was built from analyzing 12 of scientific papers and books, from web sciences and the Elsevier database. The papers were analyzed from descriptive, methodologic, and citation characteristics. Finding: By applying the equation model of the paper, the optimal no. of technician men in the crew of the workshop can be determined when
... Show MoreKinematics is the mechanics branch which dealswith the movement of the bodies without taking the force into account. In robots, the forward kinematics and inverse kinematics are important in determining the position and orientation of the end-effector to perform multi-tasks. This paper presented the inverse kinematics analysis for a 5 DOF robotic arm using the robotics toolbox of MATLAB and the Denavit-Hartenberg (D-H) parameters were used to represent the links and joints of the robotic arm. A geometric approach was used in the inverse kinematics solution to determine the joints angles of the robotic arm and the path of the robotic arm was divided into successive lines to accomplish the required tasks of the robotic arm.Therefore, this
... Show MoreHCl is separated from HCl –H2SO4 solution by membrane distillation process(MD). The flat –sheet membranes made from polyvinylidene fluoride (PVDF) and polypropylene (pp.). Plate and frame these types of membrane where used in the process. The feed is a mixture of HCl and H2SO4 acids compositions depended on metals treated object.HCl concentration increased in the permeate during the process but sulfuric acid increased gradually in the feed .During the concentration of solution acids concentrations in the feed at the beginning were 50 g/dm3 of sulfuric acid and 50 g/dm3 of hydrochloric acid at 333K feed temperature the permeate flux was 71 dm
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