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.
To assess cultural competence among nursing students from nine countries to provide an international perspective on cultural competence.
A descriptive, cross‐sectional design.
A convenience sample of 2,163 nursing students from nine countries was surveyed using the Cultural Capacity Scale from April to November 2016.
The study found a moderate range of cultural competence among the students. The ability to teach and guide other nursing colleagues to displ
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This study was designed to look for certain biochemical markers(serum uric acid and serum peroxynitrite) in women presented with obesity and to compare the level of these markers with non-obese women. A total number of 63 women were recruited from outpatients and private clinics to admit in this study. The patients were grouped into non obese women (Group I) and obese women (Group II). The anthropometric and blood pressure were determined and venous blood was obtained from each patient for determination of C-reactive protein, uric acid and peroxynitrite. The results showed that there were no significant differences in age or in concomitant or associated diseases in both groups except rheumatoid arthritis which account 80% of group I and 25%
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Biometrics is widely used with security systems nowadays; each biometric modality can be useful and has distinctive properties that provide uniqueness and ambiguity for security systems especially in communication and network technologies. This paper is about using biometric features of fingerprint, which is called (minutiae) to cipher a text message and ensure safe arrival of data at receiver end. The classical cryptosystems (Caesar, Vigenère, etc.) became obsolete methods for encryption because of the high-performance machines which focusing on repetition of the key in their attacks to break the cipher. Several Researchers of cryptography give efforts to modify and develop Vigenère cipher by enhancing its weaknesses.
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In this paper, an Integral Backstepping Controller (IBC) is designed and optimized for full control, of rotational and translational dynamics, of an unmanned Quadcopter (QC). Before designing the controller, a mathematical model for the QC is developed in a form appropriate for the IBC design. Due to the underactuated property of the QC, it is possible to control the QC Cartesian positions (X, Y, and Z) and the yaw angle through ordering the desired values for them. As for the pitch and roll angles, they are generated by the position controllers. Backstepping Controller (BC) is a practical nonlinear control scheme based on Lyapunov design approach, which can, therefore, guarantee the convergence of the position tracking
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Water saturation is the most significant characteristic for reservoir characterization in order to assess oil reserves; this paper reviewed the concepts and applications of both classic and new approaches to determine water saturation. so, this work guides the reader to realize and distinguish between various strategies to obtain an appropriate water saturation value from electrical logging in both resistivity and dielectric has been studied, and the most well-known models in clean and shaly formation have been demonstrated. The Nuclear Magnetic Resonance in conventional and nonconventional reservoirs has been reviewed and understood as the major feature of this approach to estimate Water Saturation based on T2 distribution. Artific
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The CdS quantum dots were prepared by chemical reaction
of cadmium oleylamine (Cd –oleylamine complex) with the
sulfite-oleylamine (S-oleylamine) with 1:6 mole ratios. The
optical properties structure and spectroscopy of the product
quantum dot were studied. The results show the dependence of the
optical properties on the crystal dimension and the formation of
the trap states in the energy band gap.
Thin films whose compositions can be expressed by (GeS2)100-xGax (x=0, 6,12,18) formula were obtained by thermal evaporation technique of bulk material at a base pressure of ~10-5 torr. Optical transmission spectra of the films were taken in the range of 300-1100 nm then the optical band gap, tail width of localized states, refractive index, extinction coefficient were calculated. The optical constants were found to increase at low concentration of Ga (0 to12%) while they decreases with further addition of Ga. The optical band gap was found to change in opposite manner to that of optical constants. The variation in the optical parameters are explained in terms of average bond energy
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