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.
This research aims at analysing epitaphs written by Thomas Moore for the memory of Rupert Southey, the epitaph is analysed linguistically and stylistically on four levels graphology, phonology, morphology, and lexico-syntax level to explore the elements that the writer uses the most at each level. Bearing in mind Nowottny approach (1962) (to text analysis) who believes that the linguistic analysis of a literary text is not just a marginal but a necessity” (Bakuuro etal., 2018:34). The researcher has selected and analysed a written epitaph of famous individual associated with English, literature. The study involves both literary and linguistic analysis, with much more concentration through the analysis on the aspect of linguistics. In fact
... Show MoreThis paper contains an equivalent statements of a pre- space, where are considered subsets of with the product topology. An equivalence relation between the preclosed set and a pre- space, and a relation between a pre- space and the preclosed set with some conditions on a function are found. In addition, we have proved that the graph of is preclosed in if is a pre- space, where the equivalence relation on is open.
On the other hand, we introduce the definition of a pre-stable ( pre-stable) set by depending on the concept of a pre-neighborhood, where we get that every stable set is pre-stable. Moreover, we obtain that
... Show MoreThe present study attempts to give a detailed discussion and analysis of parenthetical constructions in English and Arabic, the aim being to pinpoint the points of similarity and difference between the two languages in this particular linguistic area.The study claims that various types of constructions in English and Arabic could be considered parenthetical; these include non-restrictive relative clauses, non-restrictive appositives, comment clauses, vocatives, interjections, among others. These are going to be identified, classified, and analyzed according to the Quirk grammar - the approach to grammatical description pioneered by Randolph Quirk and his associates, and published in a series of reference grammars during the 1970
... Show MoreMany academics have concentrated on applying machine learning to retrieve information from databases to enable researchers to perform better. A difficult issue in prediction models is the selection of practical strategies that yield satisfactory forecast accuracy. Traditional software testing techniques have been extended to testing machine learning systems; however, they are insufficient for the latter because of the diversity of problems that machine learning systems create. Hence, the proposed methodologies were used to predict flight prices. A variety of artificial intelligence algorithms are used to attain the required, such as Bayesian modeling techniques such as Stochastic Gradient Descent (SGD), Adaptive boosting (ADA), Decision Tre
... Show MoreA quadruped (four-legged) robot locomotion has the potential ability for using in different applications such as walking over soft and rough terrains and to grantee the mobility and flexibility. In general, quadruped robots have three main periodic gaits: creeping gait, running gait and galloping gait. The main problem of the quadruped robot during walking is the needing to be statically stable for slow gaits such as creeping gait. The statically stable walking as a condition depends on the stability margins that calculated particularly for this gait. In this paper, the creeping gait sequence analysis of each leg step during the swing and fixed phases has been carried out. The calculation of the minimum stability margins depends up
... Show MoreSpinal dysraphism is the incomplete fusion of the neural arch, which can be seen as an occult or open neural tube defect. Meningoceles are a form of open neural tube defect characterized by cystic dilatation of the meninges containing cerebrospinal fluid without the involvement of neural tissue. Neurosurgical intervention is necessary in the newborn period since survival in advancing ages is often impossible. Therefore, meningoceles are rarely reported in adulthood. Here, we discussed a case of a 23-year-old female who presented with a meningocele in the lumbosacral area since birth, which had not been operated on. Surgical management and intraoperative findings are also discussed.