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 abstract focuses on the significance of wireless body area networks (WBANs) as a cutting-edge and self-governing technology, which has garnered substantial attention from researchers. The central challenge faced by WBANs revolves around upholding quality of service (QoS) within rapidly evolving sectors like healthcare. The intricate task of managing diverse traffic types with limited resources further compounds this challenge. Particularly in medical WBANs, the prioritization of vital data is crucial to ensure prompt delivery of critical information. Given the stringent requirements of these systems, any data loss or delays are untenable, necessitating the implementation of intelligent algorithms. These algorithms play a pivota
... Show MoreYouTube is not just a platform that individuals share, upload, comment on videos; teachers and educators can utilize it to the best maximum so that students can have benefits. This study aims at investigating how active and influential YouTube can be in the educational process and how it is beneficial for language teachers to enhance the skills of students. The study demonstrates different theoretical frameworks that tackle the employment of technology to enhance the learning/teaching process. It relies on the strategies of Berk (2009) for using multimedia media, video clips in particular to develop the abilities of teachers for using technology in classrooms. To achieve the objective of the study, the researchers develop a questionnair
... Show MoreIn every country in the world, there are a number of amputees who have been exposed to some accidents that led to the loss of their upper limbs. The aim of this study is to suggest a system for real-time classification of five classes of shoulder girdle motions for high-level upper limb amputees using a pattern recognition system. In the suggested system, the wavelet transform was utilized for feature extraction, and the extreme learning machine was used as a classifier. The system was tested on four intact-limbed subjects and one amputee, with eight channels involving five electromyography channels and three-axis accelerometer sensor. The study shows that the suggested pattern recognition system has the ability to classify the sho
... Show MoreThis research deals with the nature of the Turkish attitude towards the events of the Arab Spring which the Arab region witnessed recently, as this attitude is characterized by hesitation and utter confusion about those events at its beginning. However, the development of events and the consequent repercussions led the Turkish decision makers of the foreign policy to reconsider their attitude towards those events for political, economic, cultural and social motives.
The two-dimensional transient heat conduction through a thermal insulation of temperature dependent thermal properties is investigated numerically using the FVM. It is assumed that this insulating material is initially at a uniform temperature. Then, it is suddenly subjected at its inner surface with a step change in temperature and subjected at its outer surface with a natural convection boundary condition associated with a periodic change in ambient temperature and heat flux of solar radiation. Two thermal insulation materials were selected. The fully implicit time scheme is selected to represent the time discretization. The arithmetic mean thermal conductivity is chosen to be the value of the approximated thermal conductivity at the i
... Show MoreBACKGROUND: Polycystic ovary syndrome(PCOS) is one of the most common endocrine disorder affecting women in reproductive age. No single etiologic factor fully accounts for the spectrum of abnormalities in the polycystic ovary syndrome. Different changes in hormonal, metabolism and the inflammatory markers as squealy of PCOS with adverse effect on the women life. OBJECTIVE: To study the relationship between polycystic ovary syndrome and levels of C-reactive protein, human interleukin and hormonal and metabolic alteration in women with PCOS PATIENTS AND METHODS: Thirty women with Polycystic Ovary syndrome (PCOS) and other thirty women without PCOS were included. Venous blood samples were taken in early follicular phase of menstrual cycle [day
... Show MoreIn this paper, variable gain nonlinear PD and PI fuzzy logic controllers are designed and the effect of the variable gain characteristic of these controllers is analyzed to show its contribution in enhancing the performance of the closed loop system over a conventional linear PID controller. Simulation results and time domain performance characteristics show how these fuzzy controllers outperform the conventional PID controller when used to control a nonlinear plant and a plant that has time delay.