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 work represents development and implementation a programmable model for evaluating pumping technique and spectroscopic properties of solid state laser, as well as designing and constructing a suitable software program to simulate this techniques . A study of a new approach for Diode Pumped Solid State Laser systems (DPSSL), to build the optimum path technology and to manufacture a new solid state laser gain medium. From this model the threshold input power, output power optimum transmission, slop efficiency and available power were predicted. different systems configuration of diode pumped solid state laser for side pumping, end pump method using different shape type (rod,slab,disk) three main parameters are (energy transfer efficie
... Show MoreThe research paper talks about one of the topics that deals with one of the high-style styles in the Holy Qur’an that carries with it a high and influential style in directing the Qur’anic context, as the verses are singled out with certain words, each of which came out to other meanings, which is what was called in the past “what the wording agreed and the meaning differed Or the so-called “faces and analogues” and the meaning of analogues in the language and the Qur’an; To mention a word in a place and it means a meaning other than the other, and to interpret each word with a meaning other than the other meant by the faces, and accordingly the goal of the research is in the linguistic significance, in order to reveal the tr
... Show MoreThis research focuses on the contemporary geostrategic transformations that afflicted the countries of the Middle East, with a focus on the countries of the Arab East, after the collapse of the system of international relations, and the emergence of the unipolar system led by the United States of America. After the events of September 11 and the events that followed, especially the occupation of Iraq in 2003, the study area witnessed a group of geopolitical variables and the emergence of dangerous phenomena that threatened the state structure in the countries of the Middle East; the most notably are the phenomenon of terrorism, cross-border armed groups, sectarian polarization, the phenomenon of migration and the internal and the externa
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Synthetic anti-TB drugs are being used to treat tuberculosis (TB) as they are effective, however, they are accompanied by many side effects. The disease has remained largely uncured till date. The use of plant extracts or phytochemicals along with the anti-TB drugs is a very attractive strategy to make the treatment more effective as phytochemicals have no side-effects, are much less toxic than synthetic anti-TB drugs, are safe to use and most importantly, do not produce resistant strains as opposed to synthetic anti-TB drugs. Approximately 420,000 plant species have been identified globally and among them only a few have been explored for their therapeutic potential. Traditional medicine in different parts of the world has employed crud
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The internet, unlike other traditional means of communication, has a flexibility to stimulate the user and allows him to develop it. Perhaps, the reason for the superiority of the internet over other traditional means of communication is the possibility of change and transmission from one stage to another in a short period. This means that the internet is able to move from the use to the development of the use and then the development of means and innovation as the innovation of the internet is a logical product of the interaction of the user with the network. The internet invests all the proposals and ideas and does not ignore any even if it is simple. This is represented in social networking sites which in fact reflects personal emotio
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The CdS quantum dots were prepared by chemical reaction
of cadmium oleylamine (Cd –oleylamine complex) with the
sulfite-oleylamine (S-oleylamine) with 1:6 mole ratios. The
optical properties structure and spectroscopy of the product
quantum dot were studied. The results show the dependence of the
optical properties on the crystal dimension and the formation of
the trap states in the energy band gap.
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This paper presents a fully computerized method to backup the router configuration file. The method consists of a friendly graphical interface programmed by Java programming language.
The proposed method is compared with the two existing methods, namely: TFTP server method and Copy/Paste method. The comparison reveals that the proposed method has many advantages over the existing ones. The proposed method has been implemented on Cisco routers (series 2500, 2600 and 2800).
Background: The risk of antibiotics resistance (AR) increases due to excessive of antibiotics either by health care provider or by the patients.
Objective: The assessment of the self-medication Practice of over the counter drugs and other prescription drugs and its associated risk factor.
Subjects and Methods: Study design: A descriptive study was conducted from “20th December 2019 to 08th January 2021”. A pre validated and structured questionnaire in English and Urdu language was created to avoid language barrier including personal detail, reasons and source and knowledge about over the counter drugs and Antibiotics. Sample of the study was randomly selected.
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The goal of this paper is to design a robust controller for controlling a pendulum
system. The control of nonlinear systems is a common problem that is facing the researchers in control systems design. The Sliding Mode Controller (SMC) is the best solution for controlling a nonlinear system. The classical SMC consists from two phases. The first phase is the reaching phase and the second is the sliding phase. The SMC suffers from the chattering phenomenon which is considered as a severe problem and undesirable property. It is a zigzag motion along the switching surface. In this paper, the chattering is reduced by using a saturation function instead of sign function. In spite of SMC is a good method for controlling a nonlinear system b
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