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.
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Abstract
Pneumatic processes sequence (PPS) is used widely in industrial applications. It is common to do a predetermined PPS to achieve a specific larger task within the industrial application like the PPS achieved by the pick and place industrial robot arm. This sequence may require change depending on changing the required task and usually this requires the programmer intervention to change the sequence’ sprogram, which is costly and may take long time. In this research a PLC-based PPS control system is designed and implemented, in which the PPS is programmed by demonstration. The PPS could be changed by demonstrating the new required sequence via the user by following simple series of manual steps without h
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A study of the Torymid collection of Iraq. resulted in undescribed species of the genus
Liodontonierus Gah. L. longicorpus sp. n. with 2 figures.
Stenography is the art of hiding the very presence of communication by embedding secret message into innocuous looking cover document, such as digital image, videos, sound files, and other computer files that contain perceptually irrelevant or redundant information as covers or carriers to hide secret messages.
In this paper, a new Least Significant Bit (LSB) nonsequential embedding technique in wave audio files is introduced. To support the immunity of proposed hiding system, and in order to recover some weak aspect inherent with the pure implementation of stego-systems, some auxiliary processes were suggested and investigated including the use of hidden text jumping process and stream ciphering algorithm. Besides, the suggested
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Trickle irrigation is one of the most conservative irrigation techniques since it implies supplying water directly on the soil through emitters. Emitters dissipate energy of water at the end of the trickle irrigation system and provide water at emission points. The area wetted by an emitter depends upon the discharge of emitter, soil texture, initial soil water content, and soil permeability. The objectives of this research were to predict water distribution profiles through different soils for different conditions and quantify the distribution profiles in terms of main characteristics of soil and emitter. The wetting patterns were simulated at the end of each hour for a total time of application of 12 hrs, emitter disch
... Show MoreThe rate of gas induction was measured in gas-inducing type mechanically agitated contactors provided with two impellers. A reactor of 0.5 m i.d. was used with a working capacity of 60 liters of liquid. Tap water was used as the liquid phase, and air was used as the gas phase. The bioreactor mixing system consists of two equal diameter stirrers; the top impeller is shrouded-disk/curved-blade turbine with six evacuated bending blades, while the bottom impeller was disk turbine. The impeller speed was varied in the range of 50 to 800 rpm. The ratio of impeller diameter to tank diameter (D/T) and the submergence (S) of upper impeller from the top were varied. The effects of clearance of lower impeller from the tank bottom (C2) an
... Show MoreMedium Access Control (MAC) spoofing attacks relate to an attacker altering the manufacturer assigned MAC address to any other value. MAC spoofing attacks in Wireless Fidelity (WiFi) network are simple because of the ease of access to the tools of the MAC fraud on the Internet like MAC Makeup, and in addition to that the MAC address can be changed manually without software. MAC spoofing attacks are considered one of the most intensive attacks in the WiFi network; as result for that, many MAC spoofing detection systems were built, each of which comes with its strength and weak points. This paper logically identifies and recognizes the weak points
and masquerading paths that penetrate the up-to-date existing detection systems. Then the
A computational investigation has been carried out on the design and properties of the electrostatic mirror. In this research, we suggest a mathematical expression to represent the axial potential of an electrostatic mirror. The electron beam path under zero magnification condition had been investigated as mirror trajectory with the aid of fourth – order – Runge – Kutta method. The spherical and chromatic aberration coefficients of mirror has computed and normalized in terms of the focal length. The choice of the mirror depends on the operational requirements, i.e. each optical element in optical system has suffer from the chromatic aberration, for this case, it is use to operate the mirror in optical system at various values
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