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 study is concerned with the derivation of differential equation of motion for the free coupled vertical – torsional and lateral vibration of opened thin-walled curved beams. The curved beam to be considered in this study is of isotropic opened thin – walled (I) section with equal top and bottom flanges. The derivation depends on Hamilton's principle which required finding the potential and kinetic energy of the curved beam section due to internal stresses and all types of movements (Vertical,Torsional and Lateral) .The effect of restrained warping displacement is also considered in this study. Three differential equations are derived for vertical, torsional and lateral movement .and approximate solutions are developed by using the
... Show MoreIn this paper, we study the growth of solutions of the second order linear complex differential equations insuring that any nontrivial solutions are of infinite order. It is assumed that the coefficients satisfy the extremal condition for Yang’s inequality and the extremal condition for Denjoy’s conjecture. The other condition is that one of the coefficients itself is a solution of the differential equation .
The research deals with metaphors as being one of the primary means used by Lyudmila Ulitskaya when writing the novel " Sincerely Yours Shurik ", to form diverse and multifaceted collective female images of representatives of the classic psychological patterns presented in the work. This research reflects the results of the study related to the work of Lyudmila Yevkinevna Ulitskaya, an actress of modern Russian prose. The novel "The Sincerely to You Shorek" is one of Ludmila Ulitskaya's creations (the year of writing - 2003), which, like her other works, is distinguished by a unique presentation style, rich vocabulary, lexical and semantic diversity, and a special style of writing. writer. The main objective of the research is to look at th
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This research aims to apply the Performance Focused Activity Based Costing System in the offices of scientific and advisory services at the University of Technology for the purpose of measuring the cost of services provided by these offices in order to reduce costs. To test the hypothesis of the research, the research was applied in the consulting offices of the University of Technology through the financial statements for the year ending 12/31/2017 of the Scientific and Consulting Services Office of the University of Technology, because the data of these years were issued and audited by the Federal Office of Financial Supervision.
A number of
... Show MoreThe current research deals with the dialectical relationship resulting from the conflict in the violent combination and construction of the living ( the actor)and the dead (the item) in the structure of the Sinography construction and the emergence of the theatrical play space , which can be summed up by the following question: what is the nature of the dialectical relationship between the living (the actor) and the dead( the item) in the Sinography creation, which limited the research in a central objective : to identify the controversy of the living (actor) and the dead (item) in the performance unit of the theatrical scene . The research, in its objective limits set forth in its methodological framework, analyzes this controversy in o
... Show MoreThe article considers metaphors as one of the fundamental means used by L. Ulitskaya when writing the family chronicle "Medea and her Children" (1996), for the formation of images of heroines - representatives of the pronounced feminine principle in the work. Here I describe the results of the next stage of research related to the work of Lyudmila Evgenievna Ulitskaya as a representative of modern Russian prose.
The objective of drilling parameters optimization in Majnoon oilfield is to arrive for a methodology that considers the past drilling data for five directional wells at 35 degree of inclination as a baseline for new wells to be drilled. Also, to predicts drilling performance by selecting the applied drilling parameters generated the highest rate of penetration (ROP) at each section. The focal point of the optimization process is to reduce drilling time and associated cost per each well. The results of this study show that the maximum ROP could not be achieved without sufficient flow rate to cool and clean the bit in clay intervals (36" and 24") hole sections. Although the influence of combination of Weight on Bit (WOB), Round per minute
... Show MoreABSTRACT: Pathogenic bacteria responsible for the causation of many common diseases have been identified on currency notes. The present investigation was carried out on one hundred currency notes of all the denominations (50, 100, 250, 500 and 1000RY), obtained from different occupational mainly bus drivers, hawker street, vegetable vendor, restaurants and butchers and fish seller groups in Taiz city,Yemen. Identification and characterization revealed active participation of the following species of organisms in the ascending order of percentage as E. coli(50.28 %),Staphylococci aureus(14.04 %), Klebsiellaspp(4.39 %),proteus(4.39 %), salmonella(1.25 %), shigella(0.72 %), Coagulase negative staphylococcus(0.60 %), pseudomonas(0.50 %),
... Show MoreBox-Wilson experimental design method was employed to optimized lead ions removal efficiency by bulk liquid membrane (BLM) method. The optimization procedure was primarily based on four impartial relevant parameters: pH of feed phase (4-6), pH of stripping phase (9-11), carrier concentration TBP (5-10) %, and initial metal concentration (60-120 ppm). maximum recovery efficiency of lead ions is 83.852% was virtually done following thirty one-of-a-kind experimental runs, as exact through 24-Central Composite Design (CCD). The best values for the aforementioned four parameters, corresponding to the most restoration efficiency were: 5, 10, 7.5% (v/v), and 90 mg/l, respectively. The obtained experimental data had been
... Show MoreBlastocystosis is symptomatic infection caused by the protozoal parasite Blastocystis , which resides in the intestinal tract of its hosts and it is one of the most common parasites reported in humans. It’s prevalence ranges between (30 - 50%) of the population in developing countries. This genus has a worldwide distribution and often the most commonly reported human intestinal protozoan in children and adults, even infect infants