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.
It is axiomatic that languages mirror the world view of their users. Manipulating honorific forms among people inevitably reflects this truth . Honorifics are conventionalized forms or expressions manifested in all the world's languages and are used to express the social status of the participants in the verbal interaction and to convey indications like politeness and respect . English is no exception. However the question is what exactly creates these forms and their meanings. Although honorifics have been extensively researched from a grammatical and semantic angle , yet they haven’t received that significant attention i
... Show MoreFor the graph , the behavior associated with to the majority of the graphical properties of this graph is covered in this article. The reflection of the capabilities of on the Ly constructions is one of the key ideas addressed throughout this paper. For instance, by this technique we can comprehend the mechanism via which groups of relatively tiny structure are exist within Ly.
Drilling well design optimization reduces total Authorization for Expenditures (AFE) by decreasing well constructing time and expense. Well design is not a constant pattern during the life cycle of the field. It should be optimized by continuous improvements for all aspects of redesigning the well depending on the actual field conditions and problems. The core objective of this study is to deliver a general review of the well design optimization processes and the available studies and applications to employ the well design optimization to solve problems encountered with well design so that cost effectiveness and perfect drilling well performance are achievable. Well design optimization processes include unconventional design(slimhole) co
... Show MoreThis study sought to determine malformation caused by Ochratoxin-A (OTA) on mouse embryos. Twenty adult female white Swiss mice (mus msculus) were divided into four groups, with five females per group, and with one male placed with two females in a cage. Avaginal plug was observed in the early morning and the day of mating was considered as day of pregnancy followed by the first day of pregnancy. Three sub lethal concentrations of OTA were applied to the respective groups (other than the control), 1mg/kg, 2mg/kg and 4mg/kg. The animals were given 0.1 ml per 10 gm body weight per concentration of OTA once a day during days 7-14 of pregnancy. The control group animals were given distilled water. The pregnant mice were dissected, and the embry
... Show MoreIn this paper a nonlinear adaptive control method is presented for a pH process, which is difficult to control due to the nonlinear and uncertainties. A theoretical and experimental investigation was conducted of the dynamic behavior of neutralization process in a continuous stirred tank reactor (CSTR). The process control was implemented using different control strategies, velocity form of PI control and nonlinear adaptive control. Through simulation studies it has been shown that the estimated parameters are in good agreement with the actual values and that the proposed adaptive controller has excellent tracking and regulation performance.
Online communication on social networks has become a never-given-up way of expressing and sharing views and opinions within the realm of all topics on earth, and that is that! A basis essential in this is the limits at which "freedom of expression" should not be trespassed so as not to fall into the expression of "hate speech". These two ends make a base in the UN regulations pertaining to human rights: One is free to express, but not to hate by expression. Hereunder, a Critical Discourse Analysis in terms of Fairclough's dialectical-relational approach (2001) is made of Facebook posts (being made by common people, and not of official nature) targeting Islam and Muslims. This is made so as to recognize these instances of "speech" a
... Show MoreThis paper explores VANET topics: architecture, characteristics, security, routing protocols, applications, simulators, and 5G integration. We update, edit, and summarize some of the published data as we analyze each notion. For ease of comprehension and clarity, we give part of the data as tables and figures. This survey also raises issues for potential future research topics, such as how to integrate VANET with a 5G cellular network and how to use trust mechanisms to enhance security, scalability, effectiveness, and other VANET features and services. In short, this review may aid academics and developers in choosing the key VANET characteristics for their objectives in a single document.
Understanding the compatibility between spider silk and conducting materials is essential to advance the use of spider silk in electronic applications. Spider silk is tough, but becomes soft when exposed to water. Here we report a strong affinity of amine-functionalised multi-walled carbon nanotubes for spider silk, with coating assisted by a water and mechanical shear method. The nanotubes adhere uniformly and bond to the silk fibre surface to produce tough, custom-shaped, flexible and electrically conducting fibres after drying and contraction. The conductivity of coated silk fibres is reversibly sensitive to strain and humidity, leading to proof-of-concept sensor and actuator demonstrations.
Variable-Length Subnet Masks (VLSM), often referred to as "subnetting a subnet", is used to maximize addressing efficiency. The network administrator is able to use a long mask on networks with few hosts, and a short mask on subnets with many hosts. This addressing scheme allows growth and does not involve wasting addresses. VLSM gives a way of subnetting a network with
minimal loses of IP addresses for a specific range. Unfortunately, the network administrator has to perform several mathematical steps (or use charts) to get the required results from VLSM. In this paper, a simple graph simulator is proposed (using Visual Basic 6.0 Language) to perform all the required mathematical steps and to display the obtained required informatio
An indoor spraying robot is built in this research to solve numerous challenges associated with manual spraying. The mechanical, hardware and essential technologies used are all detailed and designed. The proposed spraying robot's conceptual design is split into two parts: hardware and software. The mechanical design, manufacturing, electrical, and electronics systems are described in the hardware part, while the control of the robot is described in the software section. This robot's kinematic and dynamic models were developed using three links that move in the x, y, and z directions. The robot was then designed using SolidWorks software to compute each connection's deflection and maximum stresses. The characteristics of the stepper moto
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