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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Abstract
The present paper attempts to detect the level of (COVID-19) pandemic panic attacks among university students, according to gender and stage variables.
To achieve this objective, the present paper adopts the scale set up by (Fathallah et al., 2021), which has been applied electronically to a previous cross-cultural sample consisting of (2285) participants from Arab countries, including Iraq. The scale includes, in its final form, (69) optional items distributed on (6) dimensions: physical symptoms (13) items, psychological and emotional symptoms (12) items, cognitive and mental symptoms (11) items, social symptoms (8) items, general symptoms (13) items and daily living practices (12) items
... Show MoreThe current theoretical research targeted to construct a model of terrorist personality and its differentiation from psychopathic personality . Several assumptions or theories of perspectives of psychopathic personality have been compared with the terrorist personality studies that concerned . The suggested theoretical model is interrupting the terrorist personality . The conclusions , discussions are mentioned. Finally, recommendation is suggested .
One and two-dimensional hydraulic models simulations are important to specify the hydraulic characteristics of unsteady flow in Al-Gharraf River in order to define the locations that facing problems and suggesting the necessary treatments. The reach in the present study is 58200m long and lies between Kut and Hai Cities. Both numerical models were simulated using HEC-RAS software, 5.0.4, with flow rates ranging from 100 to 350 m3/s. Multi-scenarios of gates openings of Hai Regulator were applied. While the openings of Al-Gharraf Head Regulator were ranged between 60cm to fully opened. The suitable manning roughness for the unsteady state was
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A compact microstrip six-port reflectometer (SPR) with extended bandwidth is proposed in this paper. The design is based on using 16-dB multi-section coupled line directional couplers and a multi-section 3-dB Wilkinson power divider operating from 1 to 6 GHz. The proposed SPR employs only two calibration standards: a matched load and an open load. As compared to other dielectric substrates, fabricating the proposed SPR involves using a low-cost (FR4) substrate. A novel algorithm is also proposed to estimate the complex reflection coefficient over the frequency ranges at which the standard performance of the circuit components is not fully satisfied. The new algorithm is based on the circles’ intersection points, which have been de
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Permeability is one of the essential petrophysical properties of rocks, reflecting the rock's ability to pass fluids. It is considered the basis for building any model to predict well deliverability. Yamama formation carbonate rocks are distinguished by sedimentary cycles that separate formation into reservoir units and insulating layers, a very complex porous system caused by secondary porosity due to substitute and dissolution processes. Those factors create permeability variables and vary significantly. Three ways used for permeability calculation, the firstly was the classical method, which only related the permeability to the porosity, resulting in a weak relationship. Secondly, the flow zone indicator (FZI) was divided reservoir into
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To determine the abilities of salivary E‐cadherin to differentiate between periodontal health and periodontitis and to discriminate grades of periodontitis.
E‐cadherin is the main protein responsible for maintaining the integrity of epithelial‐barrier function. Disintegration of this protein is one of the events associated with the destructive forms of periodontal disease leading to increase concentration of E‐cadherin in the oral biofluids.
A total of 63 patients with periodontitis (case) and 35
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Leap Motion Controller (LMC) is a gesture sensor consists of three infrared light emitters and two infrared stereo cameras as tracking sensors. LMC translates hand movements into graphical data that are used in a variety of applications such as virtual/augmented reality and object movements control. In this work, we intend to control the movements of a prosthetic hand via (LMC) in which fingers are flexed or extended in response to hand movements. This will be carried out by passing in the data from the Leap Motion to a processing unit that processes the raw data by an open-source package (Processing i3) in order to control five servo motors using a micro-controller board. In addition, haptic setup is proposed using force sensors (F
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The objective of this article is to delve into the intricate dynamics of marriage relationships, exploring the impact of emotions such as fear, love, financial considerations and likability. In our investigation, we adopt a perspective that acknowledges the nonlinear nature of interactions among individuals. Diverging from certain prior studies, we propose that the fear element within the context of marriage is not a singular, isolated factor but rather a manifestation resulting from the amalgamation of numerous social issues. This, in turn, contributes to the emergence of strained and unsuccessful relationships. Unlike conventional approaches, we extensively examine the conditions essential for the existence of all socially signifi
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As a result of the significance of image compression in reducing the volume of data, the requirement for this compression permanently necessary; therefore, will be transferred more quickly using the communication channels and kept in less space in memory. In this study, an efficient compression system is suggested; it depends on using transform coding (Discrete Cosine Transform or bi-orthogonal (tap-9/7) wavelet transform) and LZW compression technique. The suggested scheme was applied to color and gray models then the transform coding is applied to decompose each color and gray sub-band individually. The quantization process is performed followed by LZW coding to compress the images. The suggested system was applied on a set of seven stand
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