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.
In this paper a prey-predator-scavenger food web model is proposed and studied. It is assumed that the model considered the effect of harvesting and all the species are infected by some toxicants released by some other species. The stability analysis of all possible equilibrium points is discussed. The persistence conditions of the system are established. The occurrence of local bifurcation around the equilibrium points is investigated. Numerical simulation is used and the obtained solution curves are drawn to illustrate the results of the model. Finally, the nonexistence of periodic dynamics is discussed analytically as well as numerically.
Moderately, advanced national election technologies have improved political systems. As electronic voting (e-voting) systems advance, security threats like impersonation, ballot tampering, and result manipulation increase. These challenges are addressed through a review covering biometric authentication, watermarking, and blockchain technologies, each of which plays a crucial role in improving the security of e-voting systems. More precisely, the biometric authentication is being examined due to its ability in identify the voters and reducing the risks of impersonation. The study also explores the blockchain technology to decentralize the elections, enhance the transparency and ensure the prevention of any unauthorized alteration or
... Show MoreThis study presented an endeavour to integrate the value chain activities with the Balanced Scorecard for a comprehensive evaluation of an organization’s strategic performance. It also demonstrated the connection and the integration of the activities of the value chain with the Balanced Scorecard. The financial measurement was linked with non-financial measurement by integrating these techniques to achieve an appropriate performance that supports all aspects of the organizational performance. Consequently, the research problem in this study emerged, which is due to the concentration of many organizations on the measurement of financial performance. Notably, the latter caused the decline of some organizations from the competitive market. T
... Show MoreThe consumption of fresh fruits has increased nowadays due to the lifestyle of the consumers. Maintaining the quality and nutritional value of cut fruits during storage is difficult compared to whole fruits. Deterioration of internal and external quality usually occurs in freshly harvested fruits. It is necessary to use different techniques to maintain the quality and increase the shelf life of the freshly cut product. This research studied the effect of treating apple slices with cold plasma once and with filtered water again on quality characteristics (hardness, moisture content, sugar content, carbohydrate content, and color) after being stored for five days. The best treatment was determined using two different pressures of the plasma j
... Show MoreSummed up the idea of this research in an attempt to find the establishment of the knowledge convergence to show the features of verbal acts that occurred a prime location in the lesson deliberative theory book unique contract ( IbnAbdRabbaAndalusian ) to prove that Arabic was the old literary studies included many of the features of this theory in both theoretical and practical
In this paper, an intelligent tracking control system of both single- and double-axis Piezoelectric Micropositioner stage is designed using Genetic Algorithms (GAs) method for the optimal Proportional-Integral-Derivative (PID) controller tuning parameters. The (GA)-based PID control design approach is a methodology to tune a (PID) controller in an optimal control sense with respect to specified objective function. By using the (GA)-based PID control approach, the high-performance trajectory tracking responses of the Piezoelectric Micropositioner stage can be obtained. The (GA) code was built and the simulation results were obtained using MATLAB environment. The Piezoelectric Micropositioner simulation model with th
... Show MoreBackground: Community pharmacists endure significantly elevated levels of work-related stress and depression, posing a threat to their overall well-being and possibly affecting the quality of patient care. Objectives: To explore workplace-associated stress and depression in Iraqi community pharmacists. Methods: This observational study was conducted using a cross-sectional design. Information was gathered through the utilization of an internet-based survey. The study involved a community pharmacist with a minimum of one year of experience working at community pharmacies. The survey utilized pre-validated questionnaires. The level of stress experienced was assessed using the Perceived Stress Scale (PSS)-10, while the level of depression was
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