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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In this paper a nonlinear adaptive control method is presented for a pH process, which is difficult to control due to the nonlinear and uncertainties. A theoretical and experimental investigation was conducted of the dynamic behavior of neutralization process in a continuous stirred tank reactor (CSTR). The process control was implemented using different control strategies, velocity form of PI control and nonlinear adaptive control. Through simulation studies it has been shown that the estimated parameters are in good agreement with the actual values and that the proposed adaptive controller has excellent tracking and regulation performance.
Subcutaneous vascularization has become a new solution for identification management over the past few years. Systems based on dorsal hand veins are particularly promising for high-security settings. The dorsal hand vein recognition system comprises the following steps: acquiring images from the database and preprocessing them, locating the region of interest, and extracting and recognizing information from the dorsal hand vein pattern. This paper reviewed several techniques for obtaining the dorsal hand vein area and identifying a person. Therefore, this study just provides a comprehensive review of existing previous theories. This model aims to offer the improvement in the accuracy rate of the system that was shown in previous studies and
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Maxillofacial trauma in females is not widely reported. This study aimed to analyze the clinical characteristics and the patterns of maxillofacial injuries in females and to determine the differences in these patterns among different causes. This retrospective study analyzed several variables, including demographic, social, injury-related, and treatment-related variables, and compared these variables in relation to the main etiologies of maxillofacial trauma. The main etiologies of maxillofacial injuries involving females were assault, followed by road traffic accidents, and falls. There were significant differences in relation to the 3 etiologies in age groups (
Objectives: To review the failure rates of molar tubes and the effect of molar tube base design, adhesive type, and bonding technique on the failure rates of molar tubes. Data: The revolution of molar bonding greatly impacted fixed orthodontic appliance treatment by reducing chair-side time and improving patient comfort. Even with the many advantages of molar bonding, clinicians sometimes hesitate to use molar tubes due to their failure rates. Sources: Internet sources, such as Pubmed and Google Scholar. Study selection: studies testing the bond failure rate of molar tubes. Conclusions: The failure rate of the molar tubes can be reduced and the bond strength of the molar tubes can be improved by changing the design of the molar tube base
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Online communication on social networks has become a never-given-up way of expressing and sharing views and opinions within the realm of all topics on earth, and that is that! A basis essential in this is the limits at which "freedom of expression" should not be trespassed so as not to fall into the expression of "hate speech". These two ends make a base in the UN regulations pertaining to human rights: One is free to express, but not to hate by expression. Hereunder, a Critical Discourse Analysis in terms of Fairclough's dialectical-relational approach (2001) is made of Facebook posts (being made by common people, and not of official nature) targeting Islam and Muslims. This is made so as to recognize these instances of "speech" a
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This paper aims at presenting a comparison between objective and subjective tests . This paper attemptsto shed light on these two aspects of tests and make do a compression by using suitable techniques for objective and subjective tests .
The paper compares between the two techniques used by the objective and subjective tests respectively, the time and efforts required by each type, the extent to which each type can be reliable, and the skills each type is suitable to measure.
The paper shows that objective tests, on the contrary of the subjective ones, encourages guess> Objective tests are used to test specific areas of langua
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