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 Gray Wolf Optimizer (GWO) is a population-based meta-heuristic algorithm that belongs to the family of swarm intelligence algorithms inspired by the social behavior of gray wolves, in particular the social hierarchy and hunting mechanism. Because of its simplicity, flexibility, and few parameters to be tuned, it has been applied to a wide range of optimization problems. And yet it has some disadvantages, such as poor exploration skills, stagnation at local optima, and slow convergence speed. Therefore, different variants of GWO have been proposed and developed to address these disadvantages. In this article, some literature, especially from the last five years, has been reviewed and summarized by well-known publishers. Fir
... Show MoreThis research is about the resources and the way of al-Waqidi in his
researching of al-sira of the Prophet. And what happened in the first of Islam.
This research is about the documents which al-Waqidi had it. Some of it,
which he had visited, was the places, especially the periods which the events had took
place in. He was asking those whom were contemporary to the happenings, from the
sons of al-Sahaba and al-Tabi’een.
Also this research is lightening on the new studies that gave this historian a
good respect during his work, in which he could gave the reality about his authorship.
The research is trying to draw real way of al-Waqidi and what were reported by him,
especially the documents, and what he had s
Labor movement is considered important in Britain because it is an international phenomenon of the feudal system and one of the flowerings of the era of the capitalist machine. At the beginning of the 18th century, the world witnessed a change and progress in many aspects of the industrial fields such as the different means of production .this era is called the industrial revolution which especially appeared in Britain and extended to other areas of the world .it leads to many changes in Europe and participated in different economic, political and cultural and social fields. and it has a very important role in progress and development but its disadvantage is that it is exploited by the capitalists to achieve their special rights .in othe
... Show MoreLocalization is an essential issue in pervasive computing application. FM performs worse in some indoor environment when its structure is same to some extent the outdoor environment like shopping mall. Furthermore, FM signal are less varied over time, low power consumption and less effected by human and small object presence when it compared to Wi-Fi. Consequently, this paper focuses on FM radio signal technique and its characteristics that make it suitable to be used for indoor localization, its benefits, areas of applications and limitations.
Praise be to God, Lord of the worlds, and the best of prayers, and extradition was made to our master Muhammad and his whole family and companions:
And after:
Surat Al-Qariah is from the royal fence, which is in the thirtieth part of the Noble Qur’an. The commentators differed on the number of verses, and the reason for its naming. This surah talked about the conditions of people on the Day of Resurrection, and about how people were removed from their graves, all of which I spoke about in the preamble.
The research is divided into six topics: the first topic dealt with strange terms, while the second topic dealt with the most important audio issues mentioned in the surah, namely (slurring, advertising, substitution, and silenc
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 MoreAn energy and exergy thermodynamic analysis using EES program was done for a domestic refrigerator working with R-134a using vapor compression refrigeration cycle. The analysis deals with the system component, i.e. compressor, condenser, evaporator and the expansion device. The analysis depends on the entropy generation minimization approach to improve the refrigerator performance by exploring the optimum design points. These design points were derived from three different theories governing the entropy generation minimization using exergy analyzing method. These theories were first applied to find the optimum balance between the hot inner condenser area and the cold inner evaporator area of the refrigerator and between
... Show MoreA new human-based heuristic optimization method, named the Snooker-Based Optimization Algorithm (SBOA), is introduced in this study. The inspiration for this method is drawn from the traits of sales elites—those qualities every salesperson aspires to possess. Typically, salespersons strive to enhance their skills through autonomous learning or by seeking guidance from others. Furthermore, they engage in regular communication with customers to gain approval for their products or services. Building upon this concept, SBOA aims to find the optimal solution within a given search space, traversing all positions to obtain all possible values. To assesses the feasibility and effectiveness of SBOA in comparison to other algorithms, we conducte
... Show MoreThe 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.