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.
This work evaluates the influence of combining twisted fins in a triple-tube heat exchanger utilised for latent heat thermal energy storage (LHTES) in three-dimensional numerical simulation and comparing the outcome with the cases of the straight fins and no fins. The phase change material (PCM) is in the annulus between the inner and the outer tube, these tubes include a cold fluid that flows in the counter current path, to solidify the PCM and release the heat storage energy. The performance of the unit was assessed based on the liquid fraction and temperature profiles as well as solidification and the energy storage rate. This study aims to find suitable and efficient fins number and the optimum values of the Re and the inlet tem
... Show MoreIn this study, sulfur was removed from imitation oil using oxidative desulfurization process. Silicoaluminophosphate (SAPO-11) was prepared using the hydrothermal method with a concentration of carbon nanotubes (CNT) of 0% and 7.5% at 190 °C crystallization temperature. The final molar composition of the as-prepared SAPO-11 was Al2O3: 0.93P2O5: 0.414SiO2. 4% MO/SAPO-11 was prepared using impregnation methods. The produced SAPO-11 was described using X-ray diffraction (XRD) and Brunauer-Emmet-Teller (N2 adsorption–desorption isotherms). It was found that the addition of CNT increased the crystallinity of SAPO-11. The results showed that the surface area of SAPO-11 containing 7.5% CNT was 179.54 m2/g, and the pore volume was 0.31
... Show MoreThe unstable and uncertain nature of natural rubber prices makes them highly volatile and prone to outliers, which can have a significant impact on both modeling and forecasting. To tackle this issue, the author recommends a hybrid model that combines the autoregressive (AR) and Generalized Autoregressive Conditional Heteroscedasticity (GARCH) models. The model utilizes the Huber weighting function to ensure the forecast value of rubber prices remains sustainable even in the presence of outliers. The study aims to develop a sustainable model and forecast daily prices for a 12-day period by analyzing 2683 daily price data from Standard Malaysian Rubber Grade 20 (SMR 20) in Malaysia. The analysis incorporates two dispersion measurements (I
... Show MoreCommunication has seen a big advancement through ages; concepts, procedures and technologies, it has also seen a similar advancement of language. What unites language and media is the fact that each one of them guides and contributes to the other; media exists and results from language and from the other sign systems, and what strengthens this connection is the symbolic language system, as media helps it by providing knowledge and information. The change that occurred through time must leave a significant trace in the media, for example Diction, which has changed concerning development and growth, also the ways and mediums of media have become manifold and widespread. This change affected the recipient whether it was a reader, listener o
... Show Moreأثر تنوع الرؤى الاخراجية للاتجاهات والحركات المسرحية المعاصرة في أتساعالاشتراطات الجمالية لبنية الخطاب المسرحي + الامر الذي ادى الى انزياح مكوناتالعرض وعناصره ؛ ومنها المنظومة السردية للنص التي شكلت في بدايات المسرحجغرافية العرض المسرحي والمرتكز النظري والفكري الذي يمد العرض المسرحي أغلبتدفقه الجمالي وعنصر أستعلائي لعناصر العرض الاخرى ؛ وضمن التطورات اللاحقةأنسحب المخرج المسرحي من سطوة البنية النص
... Show MoreKinetics study on the phenol oxidation by catalytic wet air oxidation (CWAO) using CuO.NiO/Al2O3 as heterogeneous catalyst is presented. 4 g/l phenol solution of pH 7.3 was oxidized in a trickle bed reactor with gas flow rate of 80% stochiometric excess (S.E).. In order to verify the proposed kinetics, a series of CWAO experimental tests were done at two temperatures (140 and 160° C), oxygen partial pressures (9 and 12 bar), and weight hourly space velocity (WHSV) (1, 1.5, 2, 2.5, and 3 h-1). According to Power Law, the reaction orders are found to be approximately 1 and 0.5 with respect to phenol concentration and oxygen solubility, respectively. These values favorably compare with those cited in the literature for intrinsic kinetics,
... Show MoreThe aim of this research work is to evaluate the use of 980 nm diode laser in clotting the blood
in the bone socket after tooth extraction. The objective is to prevent possible clot dislodgement which is
a defect that may lead to possible infection. A number of rabbits were irradiated using 980nm CW mode
diode laser, 0.86W power output for 9s and 15s exposure time. The irradiated groups were studied
histopathologically in comparison with a control group. Results showed that laser photothermal
coagulation was of benefit in minimizing the possibility of the incidence of postoperative complications.
The formation of the clot reduces the possibility of bleeding and infection.
Melanoma, a highly malignant form of skin cancer, affects individuals of all genders and is associated with high mortality rates, especially in advanced stages. The use of tele-dermatology has emerged as a proficient diagnostic approach for skin lesions and is particularly beneficial in rural areas with limited access to dermatologists. However, accurately, and efficiently segmenting melanoma remains a challenging task due to the significant diversity observed in the morphology, pigmentation, and dimensions of cutaneous nevi. To address this challenge, we propose a novel approach called DenseUNet-169 with a dilated convolution encoder-decoder for automatic segmentation of RGB dermascopic images. By incorporating dilated convolution,
... Show MoreBackground: pregnancy as a systemic condition causes changes in the functioning of human body as a whole and specifically in the oral cavity and it also is considered as a stressful condition. These changes may favor the increase of oxidative stress. Aim: The aim of this study was to estimate the level of marker of oxidative stress (malondialdehyde) and antioxidant (uric acid) in saliva of pregnant compared to non-pregnant women and to assess the gingival health condition in both groups. Additionally, unstimulated salivary flow rate was determined in both groups. Subjects, materials and methods: The study group consisted of sixty pregnant women, they were divided into three equal groups according to trimester (20 pregnant women for each
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