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 estimation of the parameters of linear regression is based on the usual Least Square method, as this method is based on the estimation of several basic assumptions. Therefore, the accuracy of estimating the parameters of the model depends on the validity of these hypotheses. The most successful technique was the robust estimation method which is minimizing maximum likelihood estimator (MM-estimator) that proved its efficiency in this purpose. However, the use of the model becomes unrealistic and one of these assumptions is the uniformity of the variance and the normal distribution of the error. These assumptions are not achievable in the case of studying a specific problem that may include complex data of more than one model. To
... Show MoreThroughout this paper R represents a commutative ring with identity and all R-modules M are unitary left R-modules. In this work we introduce the notion of S-maximal submodules as a generalization of the class of maximal submodules, where a proper submodule N of an R-module M is called S-maximal, if whenever W is a semi essential submodule of M with N ⊊ W ⊆ M, implies that W = M. Various properties of an S-maximal submodule are considered, and we investigate some relationships between S-maximal submodules and some others related concepts such as almost maximal submodules and semimaximal submodules. Also, we study the behavior of S-maximal submodules in the class of multiplication modules. Farther more we give S-Jacobson radical of rings
... Show MoreThe nucleon momentum distributions (NMD) and elastic electron scattering form factors of the ground state for some 1f-2p-shell nuclei, such as 58Ni, 60Ni, 62Ni, and 64Ni
isotopes have been calculated in the framework of the coherent fluctuation model (CFM) and expressed in terms of the weight function lf(x)l2 . The weight function (fluctuation function) has been related to the nucleon density distribution (NDD) of the nuclei and determined from the theory and experiment. The NDD is derived from a simple method based on the use of the single particle wave functions of the harmonic oscillator potential and the occupation numbers of the states. The feature of the l
A reliability system of the multi-component stress-strength model R(s,k) will be considered in the present paper ,when the stress and strength are independent and non-identically distribution have the Exponentiated Family Distribution(FED) with the unknown shape parameter α and known scale parameter λ equal to two and parameter θ equal to three. Different estimation methods of R(s,k) were introduced corresponding to Maximum likelihood and Shrinkage estimators. Comparisons among the suggested estimators were prepared depending on simulation established on mean squared error (MSE) criteria.
Background: There has always been a need for valuable measurements that can be used to measure hearing loss degree in patient who cannot responses to the subjective (behavioral) tests.
Objectives: to examine the accuracy of the click - Auditory Brain stem Response (ABR) test in estimating the hearing loss degree in comparison with the behavioral tests {Free Field (FF) or Pure Tone Audiometry (PTA )}.
Subjects and method: One hundred twenty one children, with suspected hearing loss, their age between 1-9 year, 51 females and 70 males were examined in this work.
Result: The relationship between the hearing loss thresholds using the behavioral
The present paper deals with studying the effect of electrical discharge machining (EDM) and shot blast peening parameters on work piece fatigue lives using copper and graphite electrodes. Response surface methodology (RSM) and the design of experiment (DOE) were used to plan and design the experimental work matrices for two EDM groups of experiments using kerosene dielectric alone, while the second was treated by the shot blast peening processes after EDM machining. To verify the experimental results, the analysis of variance (ANOVA) was used to predict the EDM models for high carbon high chromium AISI D2 die steel. The work piece fatigue lives in terms of safety factors after EDM models were developed by FEM using ANSY
... Show MoreThe study aims to integrate the visually impaired people into the art connoisseur community through producing special print artworks to enable the visually impaired people to use their other senses to feel artworks by using artistic printing techniques through adding some prominent materials to the printing colors or making an impact that visually impaired people can perceive using their other senses. This study also aims to set up art exhibitions that display tangible works that can enable visually impaired people to feel artwork and understand its elements to enable them to feel it through other senses.
The study follows the experimental method, through using artistic printing techniques, which allow printing with prominent textur
In this paper we have presented a comparison between two novel integral transformations that are of great importance in the solution of differential equations. These two transformations are the complex Sadik transform and the KAJ transform. An uncompressed forced oscillator, which is an important application, served as the basis for comparison. The application was solved and exact solutions were obtained. Therefore, in this paper, the exact solution was found based on two different integral transforms: the first integral transform complex Sadik and the second integral transform KAJ. And these exact solutions obtained from these two integral transforms were new methods with simple algebraic calculations and applied to different problems.
... Show MoreThe ground state densities of unstable neutron-rich 11Li and 12Be exotic nuclei are studied in the framework of the binary cluster model (BCM). The internal densities of the clusters are described by the single particle harmonic oscillator wave functions. The long tail performance is clearly noticed in the calculated neutron and matter density distributions of these nuclei. The structures of the two valence neutrons in 11Li and 12Be are found to be mixed configurations with dominant (1p1/2)2. Elastic electron scattering proton form factors for 11Li and 12Be are studied using the plane wave Born approximation (PWBA). It is found that the major difference between the calculated form factors of unstable nuclei [11Li, 12Be] and those of stab
... Show MoreThe ground state charge, neutron and matter densities for two-neutron halo nuclei P
12
PBe
and P
14
PBe are calculated within a two- frequency shell model approach. In the description of
the halo nuclei it is important to take into account a model space for P
10
PBe and P
12
PBe different
from the two halo neutrons which have to be treated separately in order to explain their
properties. The structures of the halo P
12
PBe and P
14
PBe nuclei show that the dominant
configurations when the two halo neutrons distributed over the 1d shell orbits. Elastic
Coulomb scattering form factors of these two exotic nuclei are also studied through the
combination of the density distributions of