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.
Although the axial aptitude and pile load transfer under static loading have been extensively documented, the dynamic axial reaction, on the other hand, requires further investigation. During a seismic event, the pile load applied may increase, while the soil load carrying capacity may decrease due to the shaking, resulting in additional settlement. The researchers concentrated their efforts on determining the cause of extensive damage to the piles after the seismic event. Such failures were linked to discontinuities in the subsoil due to abrupt differences in soil stiffness, and so actions were called kinematic impact of the earthquake on piles depending on the outcomes of laboratory
The current study aimed to standardize the multi-position suicidal tendency scale MAST in the Saudi environment as well as to assess suicidal tendencies in adolescents. Moreover, the study aimed to test the psychometric characteristics of the scale among a sample of (490) high school and undergraduate students, in the adolescence who ranging in age from (16-21) years. The scale demonstrated satisfactory internal consistency in terms of validity and reliability tests. as the results showed of exploratory factor analysis to the four dimensions of suicidal tendencies loading on two factors that accommodate 74.60% of the overall variance of the scale (1) the attitude toward life, and absorbs 43, 20% of the total variance of the scale,
... Show MoreReceipt Date:10/11/2021 Acceptance Date:29/12/2021 Publication Date:31/12/2021
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The study aimed to clarify the conceptual explanations and the theoretical rooting of the concept of the populist phenomenon. And explore the political and cultural implications and connotations contained in populist political discourse. And to stand on the foundations and meanings on w
... Show MoreThis study aims at examining and confirming the patterns of phenetic relationships and the levels of variations within and among the species of Lotus L., 1753 in Egypt by using morphometric analysis techniques. We have evaluated 24 morphological characters from about 300 herbarium specimens representing 19 species of Lotus that are currently recognized. Based on numerical analyses of macromorphological characters (cluster analysis, principal coordinate analysis and principal component analysis), 19 species of Lotus were recognized from Egypt. These species were clustered in six species-specific groups: (I) Lotus halophilus Boiss. & Spruner, L. angustissimus L., L. glinoides Delile and L. schimperi Steud. ex Boiss., (II) Lotus glaber
... Show MoreThe total and individual multipole moments of magnetic electron scattering form factors in 41Ca have been investigated using a widely successful model which is the nuclear shell model configurations keeping in mind of 1f7/2 subshell as an L-S shell and Millinar, Baymann, Zamick as L-S shell (F7MBZ) to give the model space wave vector. Also, harmonic oscillator wave functions have been used as wave function of a single particle in 1f7/2 shell. Nucleus 40Ca as core closed and Core polarization effects have been used as a corrective with first order correction concept to basic computation of L-S shell and the excitement energy has been implemented with 2ћω. The
... Show MoreThe research talks about the most important challenges facing Muslim youth of their ideological, social and economic types, and the youth is facing several problems, the most important of which are the intellectual and social invasion to which the Islamic nation has been exposed and ways to address them from a Quranic perspective and find solutions to these problems and these challenges in accordance with Islamic Sharia and the texts of the Holy Quran. From three topics and several demands, during which the researcher tried to find solutions to each challenge through the verses of the Noble Qur’an.
After the defeat of the military terrorist organization "ISIS" and the fall of the throne of its alleged state in the Iraqi city of Nineveh, in Syrian Baghouz, and the end of its control over the land, the Syrian camps, especially "Al-Hol" camp, emerge as an incubator for the ideology of the terrorist organization "ISIS" and a vital base for its consolidation and dissemination, which includes (68,000- 73,000) people. During the years following the military defeat of (ISIS), the camp witnesses the spread of extremist ideas widely at the hands of its residents, including the families of the organizations dead's, extremist detainees, and those who deal with it, taking advantage of the deterioration of the environmental, se
... Show MoreThis work consists of a numerical simulation to predict the velocity and temperature distributions, and an experimental work to visualize the air flow in a room model. The numerical work is based on non-isothermal, incompressible, three dimensional, k turbulence model, and solved using a computational fluid dynamic (CFD) approach, involving finite volume technique to solve continuity, momentum and energy equations, that governs the room’s turbulent flow domain. The experimental study was performed using (1/5) scaled room model of the actual dimensions of the room to simulate room air flow and visualize the flow pattern using smoke generated from burnt herbs and collected in a smoke generator to delivered through
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