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.
Globally, the COVID-19 pandemic’s development has presented significant societal and economic challenges. The carriers of COVID-19 transmission have also been identified as asymptomatic infected people. Yet, most epidemic models do not consider their impact when accounting for the disease’s indirect transmission. This study suggested and investigated a mathematical model replicating the spread of coronavirus disease among asymptomatic infected people. A study was conducted on every aspect of the system’s solution. The equilibrium points and the basic reproduction number were computed. The endemic equilibrium point and the disease-free equilibrium point had both undergone local stability analyses. A geometric technique was used
... Show MoreWhen industrial and constructional renaissance started in the world, the great interest was going on towards the equipment’s, which was the first mean for production. After industry was settled the interest was going on towards the men ship which manpower on which the production depends. It was approved that it represents the basic part in all of the processes and the protection of those individuals against dangers of these equipment’s, industry and its accidents was the basic things which was studied in many researches until it crystallized in general principles for all industries and other take care in each industry.
The professional safety is concerned as restrict which
... Show MoreImplementation of TSFS (Transposition, Substitution, Folding, and Shifting) algorithm as an encryption algorithm in database security had limitations in character set and the number of keys used. The proposed cryptosystem is based on making some enhancements on the phases of TSFS encryption algorithm by computing the determinant of the keys matrices which affects the implementation of the algorithm phases. These changes showed high security to the database against different types of security attacks by achieving both goals of confusion and diffusion.
There are many studies dealt with handoff management in mobile communication systems and some of these studies presented handoff schemes to manage this important process in cellular network. All previous schemes used relative signal strength (RSS) measurements. In this work, a new proposed handoff scheme had been presented depending not only on the RSS measurements but also used the threshold distance and neighboring BSS power margins in order to improve the handoff management process. We submitted here a threshold RSS as a condition to make a handoff when a mobile station moves from one cell to another this at first, then we submitted also a specified margin between the current received signal and the ongoing BS's received signal must be s
... Show MoreThe concept of Assemblage appeared obviously in Postdramatic works, where a character or a text may stand as an assemblage of potentialities in the sense that it signifies unidentified subjectivity. Assemblages are constituted essentially of heterogeneous elements yet fused without specific demarcations. In order to enjoy the desired productivity at a "smooth pace," the regularities of political and societal institutionalization are disseminated. To achieve this dissemination, Deleuze-Guattari suggest an unsatiated platform of a "Body without Organs' (BwO), where desire escapes identification. Martin Crimp (b. 1956) defines his off-stage characters in Attempts on Her Life (1997), Anne, or whatever the name is, as a 'BwO', upon which
... Show MoreThe study aims to build a water quality index that fits the Iraqi aquatic systems and reflects the environmental reality of Iraqi water. The developed Iraqi Water Quality Index (IQWQI) includes physical and chemical components. To build the IQWQI, Delphi method was used to communicate with local and global experts in water quality indices for their opinion regarding the best and most important parameter we can use in building the index and the established weight of each parameter. From the data obtained in this study, 70% were used for building the model and 30% for evaluating the model. Multiple scenarios were applied to the model inputs to study the effects of increasing parameters. The model was built 4 by 4 until it reached 17 parame
... Show MoreAbstract: Residual ridge resorption is chronic, progressive, irreversible and cumulative condition associated with teeth loss. Management of a residual ridge with severe resorption to fulfill the patient’s esthetic and functional requirements is quite difficult for the practitioner and also in the construction of an acceptable appliance. As the height of the edentulous ridge reduces the mandibular denture will be improperly function. Severe resorption of the mandibular alveolar ridge may cause instability and discomfort of the convention acrylic resin denture. Dealing with this condition requires clinical skills and knowledge. Treating the severely resorbed mandibular ridge is a challenging effort for prosthodontics. This research present
... Show MoreHoneywords are fake passwords that serve as an accompaniment to the real password, which is called a “sugarword.” The honeyword system is an effective password cracking detection system designed to easily detect password cracking in order to improve the security of hashed passwords. For every user, the password file of the honeyword system will have one real hashed password accompanied by numerous fake hashed passwords. If an intruder steals the password file from the system and successfully cracks the passwords while attempting to log in to users’ accounts, the honeyword system will detect this attempt through the honeychecker. A honeychecker is an auxiliary server that distinguishes the real password from the fake passwords and t
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