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.
Understanding the compatibility between spider silk and conducting materials is essential to advance the use of spider silk in electronic applications. Spider silk is tough, but becomes soft when exposed to water. Here we report a strong affinity of amine-functionalised multi-walled carbon nanotubes for spider silk, with coating assisted by a water and mechanical shear method. The nanotubes adhere uniformly and bond to the silk fibre surface to produce tough, custom-shaped, flexible and electrically conducting fibres after drying and contraction. The conductivity of coated silk fibres is reversibly sensitive to strain and humidity, leading to proof-of-concept sensor and actuator demonstrations.
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Given a binary matrix, finding the maximum set of columns such that the resulting submatrix has the Consecutive Ones Property (C1P) is called the Consecutive Ones Submatrix (C1S) problem. There are solution approaches for it, but there is also a room for improvement. Moreover, most of the studies of the problem use exact solution methods. We propose an evolutionary approach to solve the problem. We also suggest a related problem to C1S, which is the Consecutive Blocks Minimization (CBM). The algorithm is then performed on real-world and randomly generated matrices of the set covering type.
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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 research deals with a very important subject as it tries to change the theoretical and scientific heritage and some professional rules adopted in the newsroom. Most media students have difficulties in writing news for press correctly. The researcher tries to identify the compatibility of what is published in local news agencies with professional and academic standards.
The research finds detailed editorial rules for a number of news formats which will play an important role in writing news for press easily, especially for the beginners and newcomers. Also, it discovers a new fact denying the beliefs of some researchers and writers in not having news conclusion in news edited according to the inverted pyramid pattern.
The re
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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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Debate is a teaching strategy in nursing education that enhances students' critical thinking. Although debate can be an effective teaching strategy, it is not without limitations. This article discusses the advantages and disadvantages of debate as a teaching strategy in nursing. Also, evaluating debates and choosing topics are highlighted.
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SummaryBackground: Rotavirus infection is the most commoncause of watery viral diarrhea in children younger than 5 years of age; it is a major cause of childhood morbidity and mortality.Objective:The aim of the study is todetermine the clinical picture, age distribution of patients with rotavirus infection and their maternal educational background.Patients &methods: A total of 202 patients suffering from diarrhea were included in this study, over 6 months period( from 1stof March 2011to 30th of August 2011),in Children Welfare Teaching hospital. History and physical examinationwere carried out, anthropometrics measures were done and plotted on Centers for Disease Control& World Health Organization charts to determine the nut
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Zinc oxide thin films were deposited by chemical spray pyrolysis onto glass substrates which are held at a temperature of 673 K. Some structural, electrical, optical and gas sensing properties of films were studied. The resistance of ZnO thin film exhibits a change of magnitude as the ambient gas is cycled from air to oxygen and nitrogen dioxide
In this paper further properties of the fuzzy complete a-fuzzy normed algebra have been introduced. Then we found the relation between the maximal ideals of fuzzy complete a-fuzzy normed algebra and the associated multiplicative linear function space. In this direction we proved that if is character on Z then ker is a maximal ideal in Z. After this we introduce the notion structure of the a-fuzzy normed algebra then we prove that the structure, st(Z) is -fuzzy closed subset of fb(Z, ) when (Z, , , ) is a commutative fuzzy complete a-fuzzy normed algebra with identity e.