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 present work is qualitative descriptive. It aims to examine the idiosyncratic schema when deciphering the selected violence-based panel from Nasser Ibrahim’s caricatures. The researchers accordingly adopted part of Sharifian’s (2011) Cultural Schema model, particularly that part that is concerned with the examining the micro/idiosyncratic level of understanding. The study has revealed that the participants have not only differed among themselves regarding the way a figure is being denotatively conceptualized, they also highlighted different exact conceptualizations for the same figure, such as: using various adjectives that reflect various levels of intensity, emphasizing the behavioral aspect or the appearance of the figure, ado
... Show MoreIn this study, pebble bed as an absorber and storage material was placed in a south facing, flat plate air-type solar collector at fixed tilt angle of (45°). The effect of this material and differ- ent parameters on collector efficiency has been investigated experimentally and
theoretically. Two operation modes were employed to study the performance of the solar air heater. An inte- grated mode of continuous operation of the system during the period of (11:00 am – 3:00 pm) and non-integrated mode in which the system stored the solar energy through the day then used the stored energy during the period of (3:00 pm – 8:00 pm). The results of parametric study in case of continuous operating showed that the maximum average temperatur
The present work investigates the effect of magneto – hydrodynamic (MHD) laminar natural convection flow on a vertical cylinder in presence of heat generation and radiation. The governing equations which used are Continuity, Momentum and Energy equations. These equations are transformed to dimensionless equations using Vorticity-Stream Function method and the resulting nonlinear system
of partial differential equations are then solved numerically using finite difference approximation. A thermal boundary condition of a constant wall temperature is considered. A computer program (Fortran 90) was built to calculate the rate of heat transfer in terms of local Nusselt number, total mean Nusselt number, velocity distribution as well as te
Rap songs often feature artists who utilize explicit language to convey feelings such as happiness, sorrow, and anger, reflecting audience expectations and trends within the music industry. This study intends to conduct a socio-pragmatic analysis of explicit, derogatory, and offensive language in the songs of the American artist Doja Cat, employing Hughes’ (1996) Swearing Word Theory, Jay’s (1996) Taboo Words Theory, Luhr’s (2002) classification of social factors for sociolinguistic examination, Salager’s (1997) categories of hedges for pragmatic assessment, and Austin’s (1965, 1989) theory of speech acts. The researchers collected the data using the AntConc corpus analysis tool. The data shows the singer’s frequent use
... Show MoreThe efforts in designing and developing lightweight cryptography (LWC) started a decade ago. Many scholarly studies in literature report the enhancement of conventional cryptographic algorithms and the development of new algorithms. This significant number of studies resulted in the rise of many review studies on LWC in IoT. Due to the vast number of review studies on LWC in IoT, it is not known what the studies cover and how extensive the review studies are. Therefore, this article aimed to bridge the gap in the review studies by conducting a systematic scoping study. It analyzed the existing review articles on LWC in IoT to discover the extensiveness of the reviews and the topics covered. The results of the study suggested that many re
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