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.
Abstract
Pneumatic processes sequence (PPS) is used widely in industrial applications. It is common to do a predetermined PPS to achieve a specific larger task within the industrial application like the PPS achieved by the pick and place industrial robot arm. This sequence may require change depending on changing the required task and usually this requires the programmer intervention to change the sequence’ sprogram, which is costly and may take long time. In this research a PLC-based PPS control system is designed and implemented, in which the PPS is programmed by demonstration. The PPS could be changed by demonstrating the new required sequence via the user by following simple series of manual steps without h
... Show MoreLet A ⊆ V(H) of any graph H, every node w of H be labeled using a set of numbers; , where d(w,v) denotes the distance between node w and the node v in H, known as its open A-distance pattern. A graph H is known as the open distance-pattern uniform (odpu)-graph, if there is a nonempty subset A ⊆V(H) together with is the same for all . Here is known as the open distance pattern uniform (odpu-) labeling of the graph H and A is known as an odpu-set of H. The minimum cardinality of vertices in any odpu-set of H, if it exists, will be known as the odpu-number of the graph H. This article gives a characterization of maximal outerplanar-odpu graphs. Also, it establishes that the possible odpu-number of an odpu-maximal outerplanar graph i
... Show MoreCharacterized the Middle East has geographic, economic, and geostrategic peculiarities, but it suffers from many problems, such as disagreement over what it means as a concept, or what it represents of a geographic extension. The question is related to the ambiguity surrounding the concept of the Middle East? The purpose of its launch? As it relates to its geostrategic, economic, and geo-cultural importance? And manifestations of this importance? And to what extent he retained his value in the strategies of the major powers? Research hypotheses:
-The multiplicity of concepts for the Middle East region, with international political and Geostrategic interests.- The geostrategic value of the Middle East has made it a focal point for
... Show MoreThe research aims to study the effect of an increase in funding the Equity by issuing new common shares on revenues ordinary shares, despite the issuance and marketing costs and the introduction of new shareholders that companies incur when issuing new common shares but it is the most important methods used to finance the Equity is funding the common shares it provides money sufficient to finance the large investments of the company and enhance the confidence of dealers with the company, so I designed this research in order to identify the impact of increased funding Equity issue new common shares to common shares revenues.
This research has included some of the theoretical concepts to each of the Equity
... Show MoreA study of the Torymid collection of Iraq. resulted in undescribed species of the genus
Liodontonierus Gah. L. longicorpus sp. n. with 2 figures.
Twelve species of philodromid crab or running crab spiders (Philodromidae) have been recorded in Armenia. Nine species are new to the spider fauna of this country: Philodromus cespitum (Walckenaer, 1802); Philodromus emarginatus (Schrank, 1803), Philodromus rufus Walckenaer, 1826; Rhysodromus histrio (Latreille, 1819), Thanatus atratus Simon, 1875; Thanatus formicinus (Clerck, 1757); Thanatus imbecillus L. Koch, 1878; Thanatus vulgaris Simon, 1870 and Thanatus pictus L. Koch, 1881.
The evolution of cryptography has been crucial to preservation subtle information in the digital age. From early cipher algorithms implemented in earliest societies to recent cryptography methods, cryptography has developed alongside developments in computing field. The growing in cyber threats and the increase of comprehensive digital communications have highlighted the significance of selecting effective and robust cryptographic techniques. This article reviews various cryptography algorithms, containing symmetric key and asymmetric key cryptography, via evaluating them according to security asset, complexity, and execution speed. The main outcomes demonstrate the growing trust on elliptic curve cryptography outstanding its capabi
... Show MoreVerrucae vulgares are commonly encountered. The present work is designed in an attempt to build a systematic procedure for treating warts by carbon dioxide laser regarding dose parameters, application parameters and laser safety.
Patients and Methods: The study done in the department of dermatology in Al-Najaf Teaching Hospital in Najaf, Iraq. Forty-two patients completed the study and follow up period for 3 months. Recalcitrant and extensive warts were selected to enter the study. Carbon dioxide laser in a continuous mode, in non-contact application, with 1 mm spot size was used. The patients were divided into two groups. The first group of patients consisted of 60 lesions divided to 6 equal groups, in whom we use different outputs a
Tendon is important structure of the human body, since it can sustain tensile loading. The primary function of this tissue is to stabilize the joints they attached to it during daily activities. As well as, tendon has viscoelastic properties that can determine their response to loading and restrict the potential of injuries. One of the major points that this paper works with is the study of the biomechanical behaviour of tendon in response to tensile loading to describe their biological behaviour. Also, conclude the mathematical expression that may illustrate the tendon behaviour. All of the experiments were made in Physiology laboratories / Medical College/ Al- Nahrain University on ten rats "Rattus Norvegicus" of [108- 360] gm weight f
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