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.
Nonmissile penetrating traumatic brain injuries (pTBIs) are low-velocity injuries which can be caused by a variety of inflicting tools and represent a rare entity in children. Poor outcome has been attributed with an initial admission Glasgow Coma Scale (GCS) of <5, asymmetrical pupil size, and specific initial computed tomography scan findings including brainstem injury.
We report a case of an 11-year-old boy who presented to our ER with a GCS of 6 after being assaulted on his head by a 30 cm length metallic tent hook penetrating his forehead reaching down to the central skull bas
In today's digital era, the importance of securing information has reached critical levels. Steganography is one of the methods used for this purpose by hiding sensitive data within other files. This study introduces an approach utilizing a chaotic dynamic system as a random key generator, governing both the selection of hiding locations within an image and the amount of data concealed in each location. The security of the steganography approach is considerably improved by using this random procedure. A 3D dynamic system with nine parameters influencing its behavior was carefully chosen. For each parameter, suitable interval values were determined to guarantee the system's chaotic behavior. Analysis of chaotic performance is given using the
... Show MoreThe present study was conducted as atrial to treat secondary hydatidosis in white mice of species Mus musculus. (Balb/c strain), experimentally infected with secondary hydatid cysts of sheep origin. The immunization process was carried by using CF/PS antigen which consist hydatid cyst fluid (CF) antigen, and protoscolices (PS) antigen mixed together and by using two concentrations 7.5, 15 mg/ml. Then derivatives of Benzimidazole, Mebendazole (M) and drugs Albendazole (A) were used 10 and 40 μm/gm body weight respectively. The mixture of drugs was used one week after challenged dose. Criteria taken into consideration to define the activity of the immunization and chemotherapy in this study were reduction in the numeral of cysts, the coeffic
... Show MoreIn this paper, some commonly used hierarchical cluster techniques have been compared. A comparison was made between the agglomerative hierarchical clustering technique and the k-means technique, which includes the k-mean technique, the variant K-means technique, and the bisecting K-means, although the hierarchical cluster technique is considered to be one of the best clustering methods. It has a limited usage due to the time complexity. The results, which are calculated based on the analysis of the characteristics of the cluster algorithms and the nature of the data, showed that the bisecting K-means technique is the best compared to the rest of the other methods used.
Photonic crystal fiber interferometers are used in many sensing applications. In this work, an in-reflection photonic crystal fiber (PCF) based on Mach-Zehnder (micro-holes collapsing) (MZ) interferometer, which exhibits high sensitivity to different volatile organic compounds (VOCs), without the needing of any permeable material. The interferometer is robust, compact, and consists of a stub photonic crystal fiber of large-mode area, photonic crystal fiber spliced to standard single mode fiber (SMF) (corning-28), this splicing occurs with optimized splice loss 0.19 dB In the splice regions the voids of the holey fiber are completely collapsed, which allows the excitation and recombination of core and cladding modes. The device reflection
... Show More