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.
Transient mixed convection heat transfer in a confined porous medium heated at periodic sinusoidal heat flux is investigated numerically in the present paper. The Poisson-type pressure equation, resulted from the substituting of the momentum Darcy equation in the continuity equation, was discretized by using finite volume technique. The energy equation was solved by a fully implicit control volume-based finite difference formulation for the diffusion terms with the use of the quadratic upstream interpolation for convective kinetics scheme to discretize the convective terms and the temperature values at the control volume faces. The numerical study covers a range of the hydrostatic pressure sinusoidal amplitude range and
... Show MoreThe comparative method plays a major role in Maupassant’s novel (A woman’s Life).This is due to a good theme choice and smooth writing style characterized by simplicity, spontaneity and brevity.
The author uses the comparative method in the introduction of his novel where he compares the monastery’s closed world to the open world of the countryside of La Normandie, which represents the dream life of the heroine Jeanne.
The present paper is an attempt to answer the question regarding the importance of applying the comparative method in the novel (A Woman’s Life) by Maupassant. The paper stresses the fact that the novelist employs the comparative method in his book for certain features .One of these features is the
... Show MoreAbstract—The upper limb amputation exerts a significant burden on the amputee, limiting their ability to perform everyday activities, and degrading their quality of life. Amputee patients’ quality of life can be improved if they have natural control over their prosthetic hands. Among the biological signals, most commonly used to predict upper limb motor intentions, surface electromyography (sEMG), and axial acceleration sensor signals are essential components of shoulder-level upper limb prosthetic hand control systems. In this work, a pattern recognition system is proposed to create a plan for categorizing high-level upper limb prostheses in seven various types of shoulder girdle motions. Thus, combining seven feature groups, w
... Show MoreStylistics is the analysis of the language of literary texts integrated within various approaches to create a framework of different devices that describe and distinct a particular work. Therefore, feminist stylistics relied on theories of feminist criticism tries to present a counter- image of a woman both in language use and society, to draw attention , raise awareness and change ways that gender represents. Feminist stylistic analysis is related not only to describe sexism in a text, but also to analyze the way that point of view, agency, metaphor, and transitivity choices are unanticipatedly and carefully connected to issues of gender(Mills,1995:1) &nb
... Show MoreIn this work, an efficient energy management (EEM) approach is proposed to merge IoT technology to enhance electric smart meters by working together to satisfy the best result of the electricity customer's consumption. This proposed system is called an integrated Internet of things for electrical smart meter (2IOT-ESM) architecture. The electric smart meter (ESM) is the first and most important technique used to measure the active power, current, and energy consumption for the house’s loads. At the same time, the effectiveness of this work includes equipping ESM with an additional storage capacity that ensures that the measurements are not lost in the event of a failure or sudden outage in WiFi network. Then then these measurement
... Show MoreMany people believe that diabetes appears after a psychological crisis, which is a misconception but it could be in them before having a crisis ore the crisis. But emotion increases the appearance of symptoms, and athletes are at risk of developing diabetes. Hypoglycemia is not unusual for athletes, and during physical activity the sugar level changes in the blood. Therefore, it is important to conduct tests for the measurement of sugar before and immediately after the activity, for the purpose of detecting the sharp drop in the sugar level and treating it, and the early detection is necessary to avoid the possibility of diabetes, the concept of psychological immunity in psychology is considered a positive concepts that maintain the balance
... Show MoreThis research evaluated the effect of (UV)(400-320A)Hz(320-220B)Hz on the patient with vitiligo , using it with our new combing therapy that include the oral (Psorlene ) topical , meladinine solution applied on the Vitiligiousns Lesions , In edition to the instralesnional injection in the Vitiligiousns Lesions by long acting steroid (kenacort-A ) by aprecentage of (5%) , after that we expose the patient to UV . The ruslets of this way of treatment more effective by using of the UV rays in the treatment of vitiligo , while the previous treatment that used the UV ray with or with out the psorlene , the results were not effective on controlling of the Vitiligio diseases comparing by the treatment used in this research as it stop’s the sp
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