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.
Abstract
This study aims to identify the repercussions of the Corona pandemic (Covid 19) and its impact on the educational and psychological functions of the Omani family from the point of view of a number of fathers and mothers. Drive for a group of fathers and mothers, some of whom work in the government sector and others are mothers enrolled in graduate studies programs at the university, their ages range between (30-50 years) totally (28) mothers and fathers: 22 mothers and 6 fathers. The results showed that the repercussions of the transformation of e-learning, home quarantine, social distancing, and the challenges associated with them were among the most frequent responses that posed a real challenge to the
... Show MoreIn this paper the research introduces a new definition of a fuzzy normed space then the related concepts such as fuzzy continuous, convergence of sequence of fuzzy points and Cauchy sequence of fuzzy points are discussed in details.
Maintaining and breeding fish in a pond are a crucial task for a large fish breeder. The main issues for fish breeders are pond management such as the production of food for fishes and to maintain the pond water quality. The dynamic or technological system for breeders has been invented and becomes important to get maximum profit return for aquaponic breeders in maintaining fishes. This research presents a developed prototype of a dynamic fish feeder based on fish existence. The dynamic fish feeder is programmed to feed where sensors detected the fish's existence. A microcontroller board NodeMCU ESP8266 is programmed for the developed h
... Show MoreA simple, sensitive and rapid method was used for the estimate of: Propranolol with Bi (III) to prove the efficiency, reliability and repeatability of the long distance chasing photometer (NAG-ADF-300-2) using continuous flow injection analysis. The method is based on a reaction between propranolol and Bi (III) in an aqueous medium to obtain a yellow precipitate. Optimum parameters were studied to increase the sensitivity for the developed method. A linear range for calibration graph was 0.1-25 mmol/L for cell A and 1-40 mmol/L for cell B, and LOD 51.8698 ng/200 µL and 363.0886 ng /200 µL , respectively to cell A and cell B with correlation coefficient (r) 0.9975 for cell A, 0.9966 for cell B, RSD% was lower than 1%, (n = 8) for the
... Show MoreAn experimental analysis was included to study and investigate the mass transport behavior of cupric ions reduction as the main reaction in the presence of 0.5M H2SO4 by weight difference technique (WDT). The experiments were carried out by electrochemical cell with a rotating cylinder electrode as cathode. The impacts of different operating conditions on mass transfer coefficient were analyzed such as rotation speeds 100-500 rpm, electrolyte temperatures 30-60 , and cupric ions concentration 250-750 ppm. The order of copper reduction reaction was investigated and it shows a first order reaction behavior. The mass transfer coefficient for the described system was correlated with the aid of dimensionless groups as fo
... Show MoreObjective conditions for the possibility of punishment are legal or material facts –positive or negative that depart from the activity of the offender. The legislator comments on their subsequent verification on the formation of some crimes the possibility of.The application of punishment to the offender , but although they are facts of an object nature that approach and overlap with many systems and cases , they are distinguished by a certain subjectivity that differentiates them from each case that may seem similar or approach them. To clarify the ambiguity that may surround these conditions , Which may lead to confusion between them and what be similar to other cases due to the common effect that they have in common , which is the f
... Show MoreExperimental and numerical studies have been conducted for the effect of injected air bubbles on the heat transfer coefficient through the water flow in a vertical pipe under the influence of uniform heat flux. The investigated parameters were water flow rate of (10, 14 and 18) lit/min, air flow rate of (1.5, 3 and 4) lit/min for subjected heat fluxes of (27264, 36316 and 45398) W/m2. The energy, momentum and continuity equations were solved numerically to describe the motion of flow. Turbulence models k-ε was implemented. The mathematical model is using a CFD code Fluent (Ansys15). The water was used as continuous phase while the air was represented as dispersed. phase. The experimental work includes design, build and instrument a test
... Show MoreThe problem of research is that the colleges of education in general and the College of Education in particular continue to follow traditional administrative patterns and that there is a complaint that the educational outputs do not match the aspirations of the society and its future directions. The aim of the research is to identify the reality of quality assurance standards in the college and to create a future vision for these standards to apply them. The researcher has designed a questionnaire based on the responses of the research sample which consisted of a group of university teachers to identify the quality assurance standards. The findings revealed that it is necessary to find a clear approach to apply the standards of quality i
... Show MorePractically, torsion is normally combined with flexure and shear actions. Even though, the behavior of reinforced concrete continuous beams under pure torsion is investigated in this study. It was performed on four RC continuous beams under pure torsion. In order to produce torsional moment on the external supports, an eccentric load was applied at various distances from the longitudinal axis of the RC beams until failure.
Variables considered in this study are absolute vertical displacement of the external supports, torsional moment’s capacity, angle of twist and first cracks occurrences. According to experimental results; when load eccentricity increased from 30cm to 60cm, the absolute vertical displacement i
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