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.
Two-dimensional unsteady mixed convection in a porous cavity with heated bottom wall is numerically studied in the present paper. The forced flow conditions are imposed by providing a hydrostatic pressure head at the inlet port that is located at the bottom of one of the vertical side walls and an open vent at the top of the other vertical side wall. The Darcy model is adopted to model the fluid flow in the porous medium and the combination effects of hydrostatic pressure head and the heat flux quantity parameters are carefully investigated. These governing parameters are varied over wide ranges and their effect on the heat transfer characteristics is studied in detail. It is found that the time required to reach a desired temperature at th
... Show MoreToday, the prediction system and survival rate became an important request. A previous paper constructed a scoring system to predict breast cancer mortality at 5 to 10 years by using age, personal history of breast cancer, grade, TNM stage and multicentricity as prognostic factors in Spain population. This paper highlights the improvement of survival prediction by using fuzzy logic, through upgrading the scoring system to make it more accurate and efficient in cases of unknown factors, age groups, and in the way of how to calculate the final score. By using Matlab as a simulator, the result shows a wide variation in the possibility of values for calculating the risk percentage instead of only 16. Additionally, the accuracy will be calculate
... Show MoreA total of (25) stool samples were collected from children and adults (2- 4) years old suffering from diarrhea to isolate E. coli strains that produce heat-stable enterotoxin a (STa), and after performing microscopic examination, cultural characterization and biochemical identification only (11) isolates showed positive E. coli. STa activity was estimated by using suckling mouse assay (SMA) and from these (11) isolates only (5) showed STa activity and the one with the highest STa activity was selected for large scale production of STa, which was followed by partial purification using ion-exchange chromatography (normal phase) using DEAE sephadex A-50 column. After purification and determination of protein concentration by using the standard
... Show MoreThe skull is one of the largest bones in the body. It is classified into flat bones that maintain the important organic structures; which are the brain, eyes, and tongue. The skull is a strong support for preserving these organs but they are various according to the type of animals and the environments in which they live and the nature of their nutrition. There are many differences among living organisms in terms of the bones in the skull, their difference or disappearance and their length in the shape of the head. The samples were taken from the scientific storage in the Iraq Natural History Research Center and Museum; Cape hare Lepus capensis (Linnaeus, 1758) and Red fox Vulpes vulpes (Linnaeus, 1758) and the study was conducted o
... Show MoreThe sensitivity of SnO2 nanoparticles/reduced graphene oxide hybrid to NO2 gas is discussed in the present work using density functional theory (DFT). The SnO2 nanoparticles shapes are taken as pyramids, as proved by experiments. The reduced graphene oxide (rGO) edges have oxygen or oxygen-containing functional groups. However, the upper and lower surfaces of rGO are clean, as expected from the oxide reduction procedure. Results show that SnO2 particles are connected at the edges of rGO, making a p-n heterojunction with a reduced agglomeration of SnO2 particles and high gas sensitivity. The DFT results are in
This paper discusses a comparative study to relate parametric and non-parametric mode decomposition algorithms for response-only data. Three popular mode decomposition algorithms are included in this study: the Eigensystem Realization Algorithm with the Natural Excitation Technique (NExT-ERA) for the parametric algorithm, as well as the Principal Component Analysis (PCA) and the Independent Component Analysis (ICA) for the non-parametric algorithms. A comprehensive parametric study is provided for (i) different response types, (ii) excitation types, (iii) system damping, and (iv) sensor spatial resolution to compare the mode shapes and modal coordinates of using a 10-DOF building model. The mode decomposition results are also compared using
... Show MoreThe primary aim of this study was to find out the effect of a training program on the development of physical abilities in football goalkeepers. The current study was conducted on goalkeepers of the Academy of Espanyol Sports Club in the premises of Haifa Sports Club Stadium. The study was completed by the researchers within the timeline of May 2021 to August 2021. A total of 7 goalkeepers falling within the age group of 15-17 years were recruited as the sample participants for the study. Out of 7 goalkeepers, 5 goalkeepers were included in the primary experiment and 2 of them were excluded. The training program applied had a positive effect on the development of physical abilities in the football goalkeepers of the sa
... Show MoreIn the present study, MCM-41 was synthesis as a carrier for poorly drugs soluble in water, by the sol-gel technique. Textural and chemical characterizations of MCM-41 were carried out by X-ray diffraction (XRD), Fourier transform infrared (FTIR), scanning electron microscope (SEM), and thermal gravimetric analysis (TGA). The experimental results were analyzed mesoporous carriers MCM-41. With maximum drug loading efficiency in MCM-41 determined to be 90.74%. The NYS released was prudently studied in simulated body fluid (SBF) pH 7.4 and the results proved that the release of NYS from MCM-41 was (87.79%) after 18 hr. The data of NYS released was found to be submitted a Weibull model with a correlation coefficient of (0.995). The Historical
... Show MoreThis paper proposes a neuro-fuzzy system to model β-glucosidase activity based on the reaction’s pH level and temperature. The developed fuzzy inference system includes two input variables (pH level and temperature) and one output (enzyme activity). The multi-input fuzzy inference system was developed in two stages: first, developing a single input-single output fuzzy inference system for each input variable (pH, temperature) separately, using the robust adaptive network-based fuzzy inference system (ANFIS) approach. The neural network learning techniques were used to tune the membership functions based on previously published experimental data for β-glucosidase. Second, each input’s optimized membership functions from the ANF
... Show MoreDespite the global economic downturn, online e-commerce, especially the sale of counterfeit goods, continues to witness a rise in sales, and one of the important players in e-commerce is the owners of e-commerce auction sites. Although they do not have a direct role in trademark infringement, they still consider them indirectly responsible (secondary liability) for infringing on their trademarks. Thus, many cases have been filed by the owners of the original trademarks (which have been infringed by persons who have sold some of the goods and products that are imitating their marks through some electronic auctions) against the owners of those auctions. In view of the international character of the Internet, in different countries, and despit
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