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.
Presentation of urinary calculus ranges from painful urination to acute retention. Diagnosed by x-ray pelvis and non-contrast CT and removal of stone by various methods is the management. Variety in symptoms, sometimes make clinical diagnosis difficult until radiological investigations confirm it. In this case presentation, initial diagnosis was made of Urethrocutaneous fistula may be due to distal stricture, but on investigating, he was diagnosed as urethral calculus in urethral diverticulum , as the reason for his symptoms
Many 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), Deci
... Show MoreThe increasing requirement and use of dental implant treatments has rendered dental implantology indispensable in dentistry. The aim of this study is to determine the optimum concentration of calcium silicate to be incorporated into a polyetherketoneketone (PEKK) matrix used as an implant material to enhance the bioactivity and mechanical properties of the composite compared with unmodified PEKK. In this study, different weight percentage (wt%) of micro-calcium silicate (m-CS) is incorporated into PEKK with ethanol as a binder. Subsequently, the mixture is dried in a forced convection oven at 120°C and poured into customized molds to fabricate a bioactive composite via compression molding (310°C, 15 MPa, and 20 min holding time
... Show MoreSince its discovery in December 2019, corona virus was outbreak worldwide with very rapid rate, so it described by WHO as pandemic. It associated with severe acute respiratory distress syndrome, and can enter to cells through Angiotensin Converting Enzyme 2 (ACE 2) receptor which play an important role as regulator for blood pressure. Hypertension is a potential risk factor for sever acute respiratory syndrome COVID-19, and associated with high mortality rate as shown in many epidemiological studies. Moreover, specific antihypertensive medications that infected patients were receiving are not known; only data about renin-angiotensin-aldosterone system (RAAS) are available.
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 MoreThe state did not witness the emergence of independent bodies because of the nature of the ruling regimes that were characterized by political tyranny represented by the king at the time, as is the case with Greece and the Greeks and Persia and the Romans and others. As for the Islamic state, which emerged later, it saw the emergence of what looks like independent bodies that we see today, There was the so-called Diwan Al-Hesba and the Ombudsman's Office as an independent body from the Islamic State, which operated independently to support the oppressed and the equitable distribution of financial resources, even though it was headed by well-known governors of justice and honesty. A state in the modern era, many countries, especially in E
... 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 image caption is the process of adding an explicit, coherent description to the contents of the image. This is done by using the latest deep learning techniques, which include computer vision and natural language processing, to understand the contents of the image and give it an appropriate caption. Multiple datasets suitable for many applications have been proposed. The biggest challenge for researchers with natural language processing is that the datasets are incompatible with all languages. The researchers worked on translating the most famous English data sets with Google Translate to understand the content of the images in their mother tongue. In this paper, the proposed review aims to enhance the understanding o
... Show Moreيمثل الأخذ بالنظام الفيدرالي أطاراً تنظيمياً لشكل الدولة و مرحلة تحول مهمة في بنية الدولة العامة في مختلف مجالاتها، فالانتقال من المركزية في أدارة الشؤون العامة للدولة الى النمط الفيدرالي يمثل تحولا بنيوياً وسيكولوجياً ،حيث يكون هنالك توزيع مكاني - عمودي للسلطة والثروة بين الوحدات المكونة للدولة بشكل يختلف كليا عن الحالة المركزية، ونجد صور تنظيمية عديدة تتأسس ضمن اطار الفيدرالية العام ،
... Show MoreA theoretical and experimental investigation was carried out to study the behavior of a two-phase closed thermosyphon loop (TPCTL) during steady-state operation using different working fluids. Three working fluids were investigated, i.e., distilled water, methanol, and ethanol. The TPCTL was constructed from an evaporator, condenser, and two pipelines (riser and downcomer). The driving force is the difference in pressure between the evaporator and condenser sections and the fluid returns to the heating section by gravity. In this study, the significant parameters used in the experiments were filling ratios (FR%) of 50%, 75%, and 100% and heat-input range at the evaporator section of 215-860.2 W. When the loop reached to
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