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.
Large amounts of plasma, the universe’s fourth most common kind of stuff, may be found across our galaxy and other galaxies. There are four types of matter in the cosmos, and plasma is the most common. By heating the compressed air or inert gases to create negatively and positively charged particles known as ions, electrically neutral particles in their natural state are formed. Many scientists are currently focusing their efforts on the development of artificial plasma and the possible advantages it may have for humankind in the near future. In the literature, there is a scarcity of information regarding plasma applications. It’s the goal of this page to describe particular methods for creating and using plasma, which may be us
... Show MoreA new concrete rheometer is introduced including its innovation, actual design, working rules,
calibration, and reliability. A modified design of Tattersall two-point device is created. Some of
components are purchased from local and foreign markets, while other components and the
manufacturing process are locally fabricated. The matching viscosity method of determining the mixer
viscometer constants is demonstrated and followed to relate torque and rotational speed to yield stress
and viscosity (Bingham parameters). The calibration procedures and its calculation are explained.
Water is used as a Newtonian fluid, while; cement paste (cement + water) with w/c ratio equal to
(0.442) is used as a non-Newtonian fluid. Th
The concept of the order sum graph associated with a finite group based on the order of the group and order of group elements is introduced. Some of the properties and characteristics such as size, chromatic number, domination number, diameter, circumference, independence number, clique number, vertex connectivity, spectra, and Laplacian spectra of the order sum graph are determined. Characterizations of the order sum graph to be complete, perfect, etc. are also obtained.
Maximum likelihood estimation method, uniformly minimum variance unbiased estimation method and minimum mean square error estimation, as classical estimation procedures, are frequently used for parameter estimation in statistics, which assuming the parameter is constant , while Bayes method assuming the parameter is random variable and hence the Bayes estimator is an estimator which minimize the Bayes risk for each value the random observable and for square error lose function the Bayes estimator is the posterior mean. It is well known that the Bayesian estimation is hardly used as a parameter estimation technique due to some difficulties to finding a prior distribution.
The interest of this paper is that
... Show MorePerhaps the issue of media and the press, especially one of the most common topics that people deliberate and deal with permanently and continuously. An issue of such significance has pushed researchers to put the following question, “Is it possible to live without media?”, “Can people ignore the newspaper, radio, TV, or the other communication means?”
The answer is very simple. It is difficult for civilized society to overtake information, or dispense with circulation, at the individual or collective level. Yet, the question of how to make the media and how it determines its content still requires extensive media experience; and knowledge of the social structure and its relations; and ac
... Show MoreThere are obstacles to high levels of hypertension awareness that are embedded in gender, income and lifestyle habits which need to be addressed leading to high levels of undiagnosed and uncontrolled hypertension. This study aimed to explore the various factors which affect hypertension awareness among a hypertensive population in a tertiary care hospital.
A quantitative study was conducted among hypertensive patients at a tertiary care hospital in Selangor, Malaysia. A validated and translated questionnaire was utilised as a data collection tool. Descriptive and inferential statistical analysis was done using SPSS version 25.
A thousand participants (female n=621, male n= 379) were recruited, and their
... Show MoreThis study aims to know how and what is the media processing presented by the television talk shows for the religious extremism topics in terms of topics, hosted personalities, and ways to address this global phenomenon.
The study is based on descriptive research, and the researcher used the analytical-survey method, analyzing the episodes of (Awkar Al Dhalam) T.V Show which was presented on Al-Iraqiya News Channel, and (Islam Hur) T.V Show which was presented on Al-Hurra in 2019 with 25 episodes from each Show, The sample and research community was chosen with the intent to cover the research problem and its
The study reached several conclusions, including:
- The various dialogs in the episo
This article discusses how women have significant abilities to cope with the difficulties of war times. They are not the weak and vulnerable victims who are thought to be. On the contrary, they have the power to control over many-sided fronts, like participating in the battlefield as nurses or activists for peace, or even fighters, as well as through the tasks and responsibilities assigned to them to protect and support their families during wartime. The researcher will examine the impact of war upon women. Like men, women suffer during wartime. They are being injured, tortured and killed. Yet, they are able to give examples of love and courage even in the difficult times of war. Hana is one of those women who lived during wartimes,
... Show More