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 surgery Keywords: Non-surgical treatment of anal fissure, fissure in ano, sphicterotomy,botulinum toxin in anal fissures, glyceryl trinitrate. Chemical sphincteratomy, pharmacological sphincteratomy.
Nanocrystalline ZnO/Zeolite type A composite was prepared by simple method of operation by . the precipitation of zinc oxide and loading on zeolite 5A in one step. Characterization was made by X-ray diffraction (XRD), X-ray fluorescence(XRF), N2 adsorption- desorption for BET surface area, and Atomic force microscopy (AFM). Results showed that zinc oxide was loaded on zeolite as noticed by the characteristic peaks and was of nano scale having an average diameter of 88.57nm. The percentage loading of ZnO on zeolite A was 28.37% and the surface area was 222m2/g. The activity of the prepared catalyst was examined in the desulfurization of double hydrogenated diesel fuel. The process was investigated in a
... Show MoreFluorescence excitation by Nd:YAG pumped dye laser and single vibrational level fluorescence
spectra of 1,3 benzodioxole in a supersonic jet have been obtained and interpreted. The previous assignment of
the 0 0
0 band was incorrect. In addition, many other bands involving n20 and n19 vibrations of a2 symmetry were
confirmed. As far as a1 totally symmetric vibration is concerned. The n14 was assigned to be located in the fivemembered
ring whereas n13 seem to be located in the benzene ring as a result of the electronic transition in the
benzene ring which affects n13 and not n14 wavenumber.
An automatic text summarization system mimics how humans summarize by picking the most significant sentences in a source text. However, the complexities of the Arabic language have become challenging to obtain information quickly and effectively. The main disadvantage of the traditional approaches is that they are strictly constrained (especially for the Arabic language) by the accuracy of sentence feature functions, weighting schemes, and similarity calculations. On the other hand, the meta-heuristic search approaches have a feature tha
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Background: The risk of antibiotics resistance (AR) increases due to excessive of antibiotics either by health care provider or by the patients.
Objective: The assessment of the self-medication Practice of over the counter drugs and other prescription drugs and its associated risk factor.
Subjects and Methods: Study design: A descriptive study was conducted from “20th December 2019 to 08th January 2021”. A pre validated and structured questionnaire in English and Urdu language was created to avoid language barrier including personal detail, reasons and source and knowledge about over the counter drugs and Antibiotics. Sample of the study was randomly selected.
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To assess cultural competence among nursing students from nine countries to provide an international perspective on cultural competence.
A descriptive, cross‐sectional design.
A convenience sample of 2,163 nursing students from nine countries was surveyed using the Cultural Capacity Scale from April to November 2016.
The study found a moderate range of cultural competence among the students. The ability to teach and guide other nursing colleagues to displ
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As technology advances and develops, the need for strong and simple authentication mechanisms that can help protect data intensifies. The contemporary approach to giving access control is through graphical passwords comprising images, patterns, or graphical items. The objective of this review was to determine the documented security risks that are related to the use of graphical passwords, together with the measures that have been taken to prevent them. The review was intended to present an extensive literature review of the subject matter on graphical password protection and to point toward potential future research directions. Many attacks, such as shoulder surfing attacks, SQL injection attacks, and spyware attacks, can easily ex
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Recent years have seen an explosion in graph data from a variety of scientific, social and technological fields. From these fields, emotion recognition is an interesting research area because it finds many applications in real life such as in effective social robotics to increase the interactivity of the robot with human, driver safety during driving, pain monitoring during surgery etc. A novel facial emotion recognition based on graph mining has been proposed in this paper to make a paradigm shift in the way of representing the face region, where the face region is represented as a graph of nodes and edges and the gSpan frequent sub-graphs mining algorithm is used to find the frequent sub-structures in the graph database of each emotion. T
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Robots have become an essential part of modern industries in welding departments to increase the accuracy and rate of production. The intelligent detection of welding line edges to start the weld in a proper position is very important. This work introduces a new approach using image processing to detect welding lines by tracking the edges of plates according to the required speed by three degrees of a freedom robotic arm. The two different algorithms achieved in the developed approach are the edge detection and top-hat transformation. An adaptive neuro-fuzzy inference system ANFIS was used to choose the best forward and inverse kinematics of the robot. MIG welding at the end-effector was applied as a tool in this system, and the wel
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Statement of the Problem. The use of orthodontic fixed appliances may adversely affect oral health leading to demineralizing lesions and the development of gingival problems. Aims of the Study. The study aimed to coat orthodontic archwires with chlorhexidine hexametaphosphate nanoparticles (CHX-HMP NPs) and to evaluate the elusion of CHX from CHX-HMP NPs. Materials and Methods. A solution of CHX-HMP nanoparticles with an overall concentration of 5 mM for both CHX and HMP was prepared, characterized (using atomic force microscope and Fourier transformation infrared spectroscopy), and used to coat orthodontic stainless steel (SSW) and NiTi archwires (NiTiW). The coated segments were characterized (using scanning electron microscopy
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