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.
The current research aims through its chapters to verify the relationship and impact of strategic leadership as an independent variable in the marketing performance as a respondent variable, in a leap cement plant, and try to come up with a set of recommendations that contribute to enhancing the practice and adoption of the two variables in the organization under discussion. And based on the importance of the research topic to the community, and to the researched organization and its members, the analytical and analytical approach was adopted in the completion of this research, and the research community included a leap cement plant in Anbar Governorate, while the research sample was represented by (department heads, and people o
... Show MoreThin films whose compositions can be expressed by (GeS2)100-xGax (x=0, 6,12,18) formula were obtained by thermal evaporation technique of bulk material at a base pressure of ~10-5 torr. Optical transmission spectra of the films were taken in the range of 300-1100 nm then the optical band gap, tail width of localized states, refractive index, extinction coefficient were calculated. The optical constants were found to increase at low concentration of Ga (0 to12%) while they decreases with further addition of Ga. The optical band gap was found to change in opposite manner to that of optical constants. The variation in the optical parameters are explained in terms of average bond energy
... Show MoreObtaining the computational models for the functioning of the brain gives us a chance to understand the brain functionality thoroughly. This would help the development of better treatments for neurological illnesses and disorders. We created a cortical model using Python language using the Brian simulator. The Brian simulator is specialized in simulating the neuronal connections and synaptic interconnections. The dynamic connection model has multiple parameters in order to ensure an accurate simulation (Bowman, 2016). We concentrated on the connection weights and studied their effect on the interactivity and connectivity of the cortical neurons in the same cortical layer and across multiple layers. As synchronization helps us to mea
... Show MoreDiabetic foot ulcer (DFU) or Lower limb ulcers are one of the major complications caused by diabetes mellitus especially when patients fail to maintain tight glycemic control. DFU is linked to multiple risk factors along with the genetic factors and ethnicity which play a significant role in the development of DFUs through their effects on multiple aspects of the pathophysiological process. This narrative review aimed to summarize all the previous studies within the last ten years associating gene polymorphism and DFU. Polymorphism associated with vascular endothelial growth factor (rs699947), the G894T polymorphism of the endothelial nitric oxide synthase gene, interleukin-6–174 G>C gene polymorphism, heat shock protein 70 gene polymorph
... Show MoreLet A ⊆ V(H) of any graph H, every node w of H be labeled using a set of numbers; , where d(w,v) denotes the distance between node w and the node v in H, known as its open A-distance pattern. A graph H is known as the open distance-pattern uniform (odpu)-graph, if there is a nonempty subset A ⊆V(H) together with is the same for all . Here is known as the open distance pattern uniform (odpu-) labeling of the graph H and A is known as an odpu-set of H. The minimum cardinality of vertices in any odpu-set of H, if it exists, will be known as the odpu-number of the graph H. This article gives a characterization of maximal outerplanar-odpu graphs. Also, it establishes that the possible odpu-number of an odpu-maximal outerplanar graph i
... Show MoreThe current study introduces a novel method for calculating the stability time by a new approach based on the conversion of degradation from the conductivity curve results obtained by the conventional method. The stability time calculated by the novel method is shorter than the time measured by the conventional method. The stability time in the novel method can be calculated by the endpoint of the tangency of the conversion curve with the tangent line. This point of tangency represents the stability time, as will be explained in detail. Still, it gives a clear and accurate envisage of the dehydrochlorination behavior and can be generalized to all types of polyvinyl chloride compared to the stability time measured by conventional ones based
... Show MoreParties as active units in this process in order to work must have access to sources of funding in order to maintain their political presence in society and participate in the process of electoral competition, To win the election, bolstering the huge role that money has played in influencing the principle of equality among contestants in the elections. Those who own money will have a greater chance of winning the elections while less competitive opportunities for others who do not own the money or what they own does not give them the competitive ability to win elections. From this point of view, controlling political finance through legal regulation and institutional, media and popular monitoring has become an important requirement
... Show MoreAmong the available chaotic modulation schemes, differential chaos shift keying (DSCK) offers the perfect noise performance. The power consumption of DCSK is high since it sends chaotic signal in both of 1 and 0 transmission, so it does not represent the optimal choice for some applications like indoor wireless sensing where power consumption is a critical issue. In this paper a novel noncoherent chaotic communication scheme called differential chaos on-off keying (DCOOK) is proposed as a solution of this problem. With the proposed scheme, the DCOOK signal have a structure similar to chaos on-off keying (COOK) scheme with improved performance in noisy and multipath channels by introducing the concept of differential coherency used in DCS
... Show MoreIn present days, drug resistance is a major emerging problem in the healthcare sector. Novel antibiotics are in considerable need because present effective treatments have repeatedly failed. Antimicrobial peptides are the biologically active secondary metabolites produced by a variety of microorganisms like bacteria, fungi, and algae, which possess surface activity reduction activity along with this they are having antimicrobial, antifungal, and antioxidant antibiofilm activity. Antimicrobial peptides include a wide variety of bioactive compounds such as Bacteriocins, glycolipids, lipopeptides, polysaccharide-protein complexes, phospholipids, fatty acids, and neutral lipids. Bioactive peptides derived from various natural sources like bacte
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