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 aim of this study is to utilize the behavior of a mathematical model consisting of three-species with Lotka Volterra functional response with incorporating of fear and hunting cooperation factors with both juvenile and adult predators. The existence of equilibrium points of the system was discussed the conditions with variables. The behavior of model referred by local stability in nearness of any an equilibrium point and the conditions for the method of approximating the solution has been studied locally. We define a suitable Lyapunov function that covers every element of the nonlinear system and illustrate that it works. The effect of the death factor was observed in some periods, leading to non-stability. To confirm the theore
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The numerical investigation has been performed to study the radiation affected steady state laminar mixed convection induced by a hot inner varied positions circular core in a horizontal rectangular channel for a fully developed flow. To examine the effects of thermal radiation on thermo fluid dynamics behavior in the eccentric geometry channel, the generalized body fitted co-ordinate system is introduced while the finite difference method is used for solving the radiative transport equation. The governing equations which used are continuity, momentum and energy equations. These equations are normalized and solved using the Vorticity-Stream function. After validating numerical results for the case without radiation, the detailed rad
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This paper and research paper analyzes the critical methodology of "Ali Khan Joommal “ about the Bible , directed in most of the textual criticism of the Torah, and its highest criticism is directed to both the Old and New Testaments.
Joommal was distinguished by the mental methods and examples accompanying his era, while maintaining the general context in which Muslim scholars had previously followed, and he was distinguished from them by his many citations to the Western literature of Jews or Christians, in short it is a critical phenomenon worthy of study and evaluation.
Evaluating treatment effect on interferon-alpha in female patients with systemic lupus erythematosus: a case-control study
The numerical investigation has been performed to study the radiation affected steady state laminar mixed convection induced by a hot inner varied positions circular core in a horizontal rectangular channel for a fully developed flow. To examine the effects of thermal radiation on thermo fluid dynamics behavior in the eccentric geometry channel, the generalized body fitted co-ordinate system is introduced while the finite difference method is used for solving the radiative transport equation. The governing equations which used are continuity, momentum and energy equations. These equations are normalized and solved using the Vorticity-Stream function. After validating numerical results for the case without radiation, the detailed radiatio
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Abstract
The Non - Homogeneous Poisson process is considered as one of the statistical subjects which had an importance in other sciences and a large application in different areas as waiting raws and rectifiable systems method , computer and communication systems and the theory of reliability and many other, also it used in modeling the phenomenon that occurred by unfixed way over time (all events that changed by time).
This research deals with some of the basic concepts that are related to the Non - Homogeneous Poisson process , This research carried out two models of the Non - Homogeneous Poisson process which are the power law model , and Musa –okumto , to estimate th
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In this research, the dynamics process of charge transfer from the sensitized D35CPDT dye to tin(iv) oxide( ) or titanium dioxide ( ) semiconductors are carried out by using a quantum model for charge transfer. Different chemical solvents Pyridine, 2-Methoxyethanol. Ethanol, Acetonitrile, and Methanol have been used with both systems as polar media surrounded the systems. The rate for charge transfer from photo-excitation D35CPDTdye and injection into the conduction band of or semiconductors vary from a to for system and from a to for the system, depending on the charge transfer parameters strength coupling, free energy, potential of donor and acceptor in the system. The charge transfer rate in D35CPDT / the syst
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The meanings attributed to Female Genital Mutilation/Cutting (FGM/C) are shaped through complex negotiations within religious and socio-cultural frameworks, including those observed in Indonesia. Using a combined qualitative and quantitative (mixed methods)-ethnographic and survey approach, data from 109 students of religious tertiary institutions in East Kalimantan on their perspectives on FGM/C practices can be more comprehensively explored. The results of the study, which were analysed using the three principles of symbolic interactionism, showed that 72.5 per cent of religious college student families still practice FGM/C and 53.2 per cent stated that FGM/C practices are beneficial for women. However, they are also willing, if
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