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 fall angle of sun rays on the surface of a photovoltaic PV panel and its temperature is negatively affecting the panel electrical energy produced and efficiency. The fall angle problem was commonly solved by using a dual-axis solar tracker that continually maintains the panel orthogonally positioning to the sun rays all day long. This leads to maximum absorption for solar radiation necessary to produce maximum amount of energy and maintain high level of electrical efficiency. To solve the PV panel temperature problem, a Water-Flow Double Glazing WFDG technique has been introduced as a new cooling tool to reduce the panel temperature. In this paper, an integration design of the water glazing system with a dual-axis tracker has been ac
... Show MoreThe Security Council has an active role in addressing international crises and dealing with their causes. The Libyan crisis is one of the most important real tests of the Security Council and its role in maintaining international peace and security, as the Council has proven so far an ineffective role in resolving the crisis and dealing withtheir causes, which has prolonged its duration and increased its complexities and dangerous repercussions, perhaps the most prominent of which is the threat of the recently achieved cease-fire and the formation of a new transitional government led by Abdel Hamid al-Dabaiba, the growing significant obstacles facing the political process, foremost of which is the continued presence of foreign forces , m
... Show MoreThis paper is devoted to an inverse problem of determining discontinuous space-wise dependent heat source in a linear parabolic equation from the measurements at the final moment. In the existing literature, a considerably accurate solution to the inverse problems with an unknown space-wise dependent heat source is impossible without introducing any type of regularization method but here we have to determine the unknown discontinuous space-wise dependent heat source accurately using the Haar wavelet collocation method (HWCM) without applying the regularization technique. This HWCM is based on finite-difference and Haar wavelets approximation to the inverse problem. In contrast to othe
Alice Walker's novel The Color Purple1983, whose events take place in the rural Georgia and addresses the most important issues in the early 20thcentury; like male dominant society and women submission to men, weaves a mosaic picture of male-female relationships. Black men like Alphonso, Albert and Harpo are portrayed as oppressors, cruel and they exercise power and violence over their wives and daughters. Through the negative portrayal of black male characters, Walker is accused to be a men hating writer because she ''Views oppression as an essentially masculine activity which springs from the male's aggressive need to dominate. In the novel, man is the premium mobile, the one by whom and t
... Show MoreThe use of Near-Surface Mounted (NSM) Carbon-Fiber-Reinforced Polymer (CFRP) strips is an efficient technology for increasing flexural and shear strength or for repairing damaged Reinforced Concrete (RC) members. This strengthening method is a promising technology. However, the thin layer of concrete covering the NSM-CFRP strips is not adequate to resist heat effect when directly exposed to a fire or at a high temperature. There is clear evidence that the strength and stiffness of CFRPs severely deteriorate at high temperatures. Therefore, in terms of fire resistance, the NSM technique has a significant defect. Thus, it is very important to develop a set of efficient fire protection systems to overcome these disadvantages. This pape
... Show MoreThis study evaluated the structural changes of enamel treated by the Regenerate system and carbon dioxide (CO2) laser against acid challenge. Thirty human enamel slabs were prepared and assigned into three groups: Group I: untreated (control); Group II: treated with the Regenerate system; and Group III exposed to CO2 laser. All specimens were subjected to an acid challenge (pH 4.5–7.0) for 14 days. Specimens were evaluated and compared at 120 points using five Raman microspectroscopic peaks; the phosphate vibrations ν1, ν2, ν3, and ν4 at 960, 433, 1029, and 579 cm−1, respectively, and the carbonate at 1070 cm−1, followed by Vickers microhardness test. The ratio of carbonate to phosphate was correlated to the equivalent mic
... Show MorePoetry is regarded an interesting area of inquiry in linguistic studies due to its eccentric and aesthetic use of language. A lot of studies have been carried out so far for the analysis of poetry, yet few have dealt with pastoral poetry. The present research attempts to investigate the language of pastoral poetry in two different languages i.e. English and Arabic with the aim of finding similarities and differences. The data of the study consists of one English and one Arabic pastoral poems. Leech and Short's (2007) checklist is used as a model for analysis. The findings of the study reveal that there are more similarities than differences between English and Arabic pastoral poems as the poems rely on contrast
... Show MoreIn this paper, we introduce the concept of cubic bipolar-fuzzy ideals with thresholds (α,β),(ω,ϑ) of a semigroup in KU-algebra as a generalization of sets and in short (CBF). Firstly, a (CBF) sub-KU-semigroup with a threshold (α,β),(ω,ϑ) and some results in this notion are achieved. Also, (cubic bipolar fuzzy ideals and cubic bipolar fuzzy k-ideals) with thresholds (α,β),(ω ,ϑ) are defined and some properties of these ideals are given. Relations between a (CBF).sub algebra and-a (CBF) ideal are proved. A few characterizations of a (CBF) k-ideal with thresholds (α, β), (ω,ϑ) are discussed. Finally, we proved that a (CBF) k-ideal and a (CBF) ideal with thresholds (α, β), (ω,ϑ) of a KU-semi group are equivalent relations.
The purpose of this paper is to apply different transportation models in their minimum and maximum values by finding starting basic feasible solution and finding the optimal solution. The requirements of transportation models were presented with one of their applications in the case of minimizing the objective function, which was conducted by the researcher as real data, which took place one month in 2015, in one of the poultry farms for the production of eggs
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