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.
Distributed Denial of Service (DDoS) attacks on Web-based services have grown in both number and sophistication with the rise of advanced wireless technology and modern computing paradigms. Detecting these attacks in the sea of communication packets is very important. There were a lot of DDoS attacks that were directed at the network and transport layers at first. During the past few years, attackers have changed their strategies to try to get into the application layer. The application layer attacks could be more harmful and stealthier because the attack traffic and the normal traffic flows cannot be told apart. Distributed attacks are hard to fight because they can affect real computing resources as well as network bandwidth. DDoS attacks
... Show MoreThe focus of this article, reviewed a generalized of contraction mapping and nonexpansive maps and recall some theorems about the existence and uniqueness of common fixed point and coincidence fixed-point for such maps under some conditions. Moreover, some schemes of different types as one-step schemes ,two-step schemes and three step schemes (Mann scheme algorithm, Ishukawa scheme algorithm, noor scheme algorithm, .scheme algorithm, scheme algorithm Modified scheme algorithm arahan scheme algorithm and others. The convergence of these schemes has been studied .On the other hands, We also reviewed the convergence, valence and stability theories of different types of near-plots in convex metric space.
Acid treatment is a widely used stimulation technique in the petroleum industry. Matrix acidizing is regarded as an effective and efficient acidizing technique for carbonate formations that leads to increase the fracture propagation, repair formation damage, and increase the permeability of carbonate rocks. Generally, the injected acid dissolves into the rock minerals and generates wormholes that modify the rock structure and enhance hydrocarbon production. However, one of the key issues is the associated degradation in the mechanical properties of carbonate rocks caused by the generated wormholes, which may significantly reduce the elastic properties and hardness of rocks. There have been several experimental and simulation studies regardi
... Show MoreEarly detection of brain tumors is critical for enhancing treatment options and extending patient survival. Magnetic resonance imaging (MRI) scanning gives more detailed information, such as greater contrast and clarity than any other scanning method. Manually dividing brain tumors from many MRI images collected in clinical practice for cancer diagnosis is a tough and time-consuming task. Tumors and MRI scans of the brain can be discovered using algorithms and machine learning technologies, making the process easier for doctors because MRI images can appear healthy when the person may have a tumor or be malignant. Recently, deep learning techniques based on deep convolutional neural networks have been used to analyze med
... Show MoreThe using of recycled aggregates from construction and demolition waste (CDW) can preserve natural aggregate resources, reduce the demand for landfill, and contribute to a sustainable built environment. Concrete demolition waste has been proven to be an excellent source of aggregates for new concrete production. At a technical, economic, and environmental level, roller compacted concrete (RCC) applications benefit various civil construction projects. Roller Compacted Concrete (RCC) is a homogenous mixture that is best described as a zero-slump concrete placed with compacting equipment, uses in storage areas, dams, and most often as a basis for rigid pavements. The mix must be sufficiently dry to support
... Show MoreResearchers dream of developing autonomous humanoid robots which behave/walk like a human being. Biped robots, although complex, have the greatest potential for use in human-centred environments such as the home or office. Studying biped robots is also important for understanding human locomotion and improving control strategies for prosthetic and orthotic limbs. Control systems of humans walking in cluttered environments are complex, however, and may involve multiple local controllers and commands from the cerebellum. Although biped robots have been of interest over the last four decades, no unified stability/balance criterion adopted for stabilization of miscellaneous walking/running modes of biped
Rotational Piezoelectric Energy Harvesting (RPZTEH) is widely used due to mechanical rotational input power availability in industrial and natural environments. This paper reviews the recent studies and research in RPZTEH based on its excitation elements and design and their influence on performance. It presents different groups for comparison according to their mechanical inputs and applications, such as fluid (air or water) movement, human motion, rotational vehicle tires, and other rotational operational principal including gears. The work emphasises the discussion of different types of excitations elements, such as mass weight, magnetic force, gravity force, centrifugal force, gears teeth, and impact force, to show their effect
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