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.
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The problem of the paper focused on the role of the learning organization in the crisis management strategy, and the extent of the actual interest in both the learning organization and the crisis management and aimed at diagnosing and analyzing that and surrounding questions. The Statistical Package for the Social Sciences (SPSS) program was used to calculate the results and the correlation coefficient between the two main variables. The methodology was descriptive and analytical. The case study was followed by a questionnaire that was distributed to a sample of 31 teachers. The paper adopted a seven-dimensional model of systemic thinking that encourages questioning, empowerment, provision of advanced technologies, and strategic lea
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Amorphization of drug has been considered as an attractive approach in improving drug solubility and bioavailability. Unlike their crystalline counterparts, amorphous materials lack the long-range order of molecular packing and present the highest energy state of a solid material. Co-amorphous systems (CAM) are an innovative formulation technique by where the amorphous drugs are stabilized via powerful intermolecular interactions by means of a low molecular co-former.
This review highlights the different approaches in the preparation of co-amorphous drug delivery system, the proper selection of the co-formers. In addition, the recent advances in characterization, Industrial scale and formulation will be discussed.
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It is proposed and studied a prey-predator system with a Holling type II functional response that merges predation fear with a predator-dependent prey's refuge. Understanding the impact of fear and refuge on the system's dynamic behavior is one of the objectives. All conceivable steady-states are investigated for their stability. The persistence condition of the system has been established. Local bifurcation analysis is performed in the Sotomayor sense. Extensive numerical simulation with varied parameters was used to explore the system's global dynamics. A limit cycle and a point attractor are the two types of attractors in the system. It's also interesting to note that the system exhibits bi-stability between these 2 types of attractors.
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Autoimmune hepatitis is an inflammatory disease and its incidence has been increasing. The features of hepatitis are the release of inflammatory cytokines, the elevation of AST and ALT, and hepatocyte apoptosis and necrosis. Concanavalin A considered as essential model represents the acute immune-mediated liver damage in rodents. Thymoquinone is well known herbal compound that exert hepatoprotective, anti-inflammatory, and antioxidant activity. In this study, we focus on the immunoregulatory and liver protective effect of thymoquinone in a mouse model of concanavalin A-induced liver injury.
Twenty-four male mice were randomly divided into four groups each containing six animals: Negative control group, concanavalin A model group,
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Many authors investigated the problem of the early visibility of the new crescent moon after the conjunction and proposed many criteria addressing this issue in the literature. This article presented a proposed criterion for early crescent moon sighting based on a deep-learned pattern recognizer artificial neural network (ANN) performance. Moon sight datasets were collected from various sources and used to learn the ANN. The new criterion relied on the crescent width and the arc of vision from the edge of the crescent bright limb. The result of that criterion was a control value indicating the moon's visibility condition, which separated the datasets into four regions: invisible, telescope only, probably visible, and certai
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