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 surgeryKeywords: Non-surgical treatment of anal fissure, fissure in ano, sphicterotomy,botulinum toxin in anal fissures, glyceryl trinitrate. Chemical sphincteratomy, pharmacological sphincteratomy.
This paper studies the demonstratives as deictic expressions in Standard Arabic and English by outlining their phonological, syntactic and semantic properties in the two languages. On the basis of the outcome of this outline, a contrastive study of the linguistic properties of this group of deictic expressions in the two languages is conducted next. The aim is to find out what generalizations could be made from the results of this contrastive study.
Praise be to God, and prayers and peace be upon our master Muhammad, the Messenger of God, and upon his family, companions, and those who are guided by his guidance.
Then:
Our Islamic jurisprudence and its basic principles are fixed, namely: the Noble Qur’an, then the Prophet’s Sunnah, then consensus, then analogy. However, it is characteristic of what makes it developed to meet the requirements of renewed life, including: sent interests, custom, approval, blocking pretexts, changing times. That is why it went through different stages, growth, brilliance, stagnation and endowment; Therefore, many scholars of Islamic jurisprudence divided its stages into four sections: the stage of inf
... Show MoreThe maximization of the net present value of the investment in oil field improvements is greatly aided by the optimization of well location, which plays a significant role in the production of oil. However, using of optimization methods in well placement developments is exceedingly difficult since the well placement optimization scenario involves a large number of choice variables, objective functions, and restrictions. In addition, a wide variety of computational approaches, both traditional and unconventional, have been applied in order to maximize the efficiency of well installation operations. This research demonstrates how optimization approaches used in well placement have progressed since the last time they were examined. Fol
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Plagiarism is becoming more of a problem in academics. It’s made worse by the ease with which a wide range of resources can be found on the internet, as well as the ease with which they can be copied and pasted. It is academic theft since the perpetrator has ”taken” and presented the work of others as his or her own. Manual detection of plagiarism by a human being is difficult, imprecise, and time-consuming because it is difficult for anyone to compare their work to current data. Plagiarism is a big problem in higher education, and it can happen on any topic. Plagiarism detection has been studied in many scientific articles, and methods for recognition have been created utilizing the Plagiarism analysis, Authorship identification, and
... Show MoreThere are many ways to communicate a story, one can tell it, sing it, act it, write it, film it and can draw it. Each form of storytelling has its unique characteristics that separate it from the other forms. These distinguishing characteristics of each form does not indicate the superiority of one form over the other, on the contrary, it indicates the human ability to be creative on many levels. As students of literature, only the written form of a story is taken into account. One reason for the negligence of other forms of storytelling might be that singing and filming a story is not related to literature. But there has been a form of storytelling that uses words along with pictures which eventually became a genre of novels called grap
... Show MoreA prepared PMMA/Anthracene film of thickness 70μm was irradiated under reduced pressure ~10-3 to 60Coγ-ray dose of (0.1mrad-10krad) range. The optical properties of the irradiated films were evaluated spectrophotometrically. The absorption spectrum showed induced absorption changes in the 200-400nm range. At 359nm, where there is a decrease in radiation-induced absorption, the optical density as a function of absorbed dose is linear from 10mrad-10Krad.It can therefore, be used as radiation dosimeter for gamma ray in the range 10mrd-10krad
Objective: Geographic differences in clinical and pathological aspects of ameloblastoma have been suggested, therefore the purpose of this study was to analyze cases of ameloblastoma in terms of clinical and radiographic manifestations, histopathological types, treatment modalities and recurrence rate and compare them with reports from other parts of the world. Methods: The medical reports of patients diagnosed with ameloblastoma were reviewed and the data concerning the age, gender, chief complaint, the anatomical site of the lesion, radiographic appearance, histopathological diagnosis, treatment approach and recurrence were retrieved. Surgical treatment consisted of either enucleation with curettage and peripheral ostectomy or resection;
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In this study, the dynamic modeling and step input tracking control of single flexible link is studied. The Lagrange-assumed modes approach is applied to get the dynamic model of a planner single link manipulator. A Step input tracking controller is suggested by utilizing the hybrid controller approach to overcome the problem of vibration of tip position through motion which is a characteristic of the flexible link system. The first controller is a modified version of the proportional-derivative (PD) rigid controller to track the hub position while sliding mode (SM) control is used for vibration damping. Also, a second controller (a fuzzy logic based proportional-integral plus derivative (PI+D) control scheme) is developed for both vibra
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The seizure epilepsy is risky because it happens randomly and leads to death in some cases. The standard epileptic seizures monitoring system involves video/EEG (electro-encephalography), which bothers the patient, as EEG electrodes are attached to the patient’s head.
Seriously, helping or alerting the patient before the seizure is one of the issue that attracts the researchers and designers attention. So that there are spectrums of portable seizure detection systems available in markets which are based on non-EEG signal.
The aim of this article is to provide a literature survey for the latest articles that cover many issues in the field of designing portable real-time seizure detection that includes the use of multiple
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