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 study aims to study argumentation in political debates by figuring out the logical fallacies employed in the debates of Clinton and Trump, the presidential nominees of the 2016 elections, and Biden and Trump, the leading contenders in the 2020 United States presidential election. The study attempts to answer the questions: (1) What relevance fallacies are adopted in the debate between Trump and Clinton? (2) What rhetorical devices are used to influence the audience and gain voters besides fallacies in the debates selected? The study analyses two texts from two arguments using Damer's (2009) taxonomy of relevance fallacy and rhetorical devices based on Perrine’s (1969) model of communication and interpersonal rhetoric to answe
... Show MoreBackground: Elastomeric chains are used to generate force in many orthodontic procedures, but this force decays over time, which could affect tooth movement. This study aimed to study the force degradation of elastomeric chains. Data and Sources: An electronic search on Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, LILACS, and PubMed was made, only articles written in English were included, up to January 2022.Study selection: Fifty original articles, systematic reviews, and RCTs were selected. Conclusion: Tooth movement, salivary enzymes, alcohol-containing mouthwash, whitening mouthwash, and alkaline and strong acidic (pH <5.4) solutions all have a significant impact on elastomeric chain force degradation. T
... Show MoreSpinal dysraphism is the incomplete fusion of the neural arch, which can be seen as an occult or open neural tube defect. Meningoceles are a form of open neural tube defect characterized by cystic dilatation of the meninges containing cerebrospinal fluid without the involvement of neural tissue. Neurosurgical intervention is necessary in the newborn period since survival in advancing ages is often impossible. Therefore, meningoceles are rarely reported in adulthood. Here, we discussed a case of a 23-year-old female who presented with a meningocele in the lumbosacral area since birth, which had not been operated on. Surgical management and intraoperative findings are also discussed.
There are many studies dealt with handoff management in mobile communication systems and some of these studies presented handoff schemes to manage this important process in cellular network. All previous schemes used relative signal strength (RSS) measurements. In this work, a new proposed handoff scheme had been presented depending not only on the RSS measurements but also used the threshold distance and neighboring BSS power margins in order to improve the handoff management process. We submitted here a threshold RSS as a condition to make a handoff when a mobile station moves from one cell to another this at first, then we submitted also a specified margin between the current received signal and the ongoing BS's received signal must be s
... Show MoreMany academics have concentrated on applying machine learning to retrieve information from databases to enable researchers to perform better. A difficult issue in prediction models is the selection of practical strategies that yield satisfactory forecast accuracy. Traditional software testing techniques have been extended to testing machine learning systems; however, they are insufficient for the latter because of the diversity of problems that machine learning systems create. Hence, the proposed methodologies were used to predict flight prices. A variety of artificial intelligence algorithms are used to attain the required, such as Bayesian modeling techniques such as Stochastic Gradient Descent (SGD), Adaptive boosting (ADA), Decision Tre
... Show MoreThe present study aims at analyzing the polysemy of the English preposition in from the cognitive linguistic (CL) point of view using Evans' and Tyler's approach (2003). The perplexity faced by Iraqi second language learners (L2) due to the multi-usages of this preposition has motivated the researcher to conduct this study. Seventy-six second year university students participated in this experimental study. The data of the pre-test and post-test were analyzed by SPSS statistical editor. The results have shown the following: First, a progress of more than (0.05≤) has been detected as far as students' understanding of the multiple usages of the preposition in is concerned. Second, the results of the questionnaire have s
... Show MoreGiven a matrix, the Consecutive Ones Submatrix (C1S) problem which aims to find the permutation of columns that maximizes the number of columns having together only one block of consecutive ones in each row is considered here. A heuristic approach will be suggested to solve the problem. Also, the Consecutive Blocks Minimization (CBM) problem which is related to the consecutive ones submatrix will be considered. The new procedure is proposed to improve the column insertion approach. Then real world and random matrices from the set covering problem will be evaluated and computational results will be highlighted.
This research was aimed to study the osmotic efficiency of the draw solutions and the factors affecting the performance of forward osmosis process : The draw solutions used were magnesium sulfate hydrate (MgSO4.7H2O) pojtassium chloride (KCL), calcium chloride (CaCl2) and ammonium bicarbonate (NH4HCO3). It was found that water flux increases with increasing draw solution concentration, and feed solution flow rate and decreases with increasing draw solution flow rate and feed solution concentration. And also found that the efficiency of the draw solutions is in the following order:
CaCl2> KCI > NH4HCO3> MgSO4.7H