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.
Due to the importance of nanotechnology because of its features and applications in various fields, it has become the focus of attention of the world and researchers. In this study, the concept of nanotechnology and nanomaterials was identified, the most important methods of preparing them, as well as the preparation techniques and the most important devices used in their characterization.
Since the law is the tool for implementing the state’s public policies, it is natural that its provisions (or at least some of them) seek to preserve human dignity as the source on which all rights and freedoms are based. One of the examples of humanizing the provisions of the law in France is what is known as the winter truce. What is this truce, what are the justifications for granting it, what is its historical origin, how did the legislative treatment of it develop, what are the similarities and differences between it and other legal periods included in French law, what is the scope of its application, and what are the effects resulting from it. These questions and others are what we will try to answer through this research.
Futsal and blind football are group games of a competitive nature due to their excitement, excitement, fun, and aesthetic goals with charming artistic touches. This explains the public's passion for these two games, whether healthy people or blind people play them, to expand their vision and knowledge. About these two games, a historical approach is presented about their origins, development, and how they became globally recognized competitive sports with unified rules and world championships at various levels. Studying the origin and global spread of both futsal and blind football and identifying the most prominent developments in the rules and tools for futsal and blind football. The most important findings were that both futsal and footb
... Show MoreIn this work, a numerical study is performed to predict the solution of two – dimensional, steady and laminar mixed convection flow over a square cylinder placed symmetrically in a vertical parallel plate. A finite difference method is employed to solve the governing differential equations, continuity, momentum, and energy equation balances. The solution is obtained for stream function, vorticity and temperature as dependent variables by iterative technique known as successive over relaxation. The flow and temperature patterns are obtained for Reynolds number and Grashof number at (Re= -50,50,100,-100) (positive or negative value refers to aidding or opposing buoyancy , +1 assisting flow, -1 opposing flow) and (102 to 105) , respective
... Show MoreBecause of cost-effective production and abundant resources of calcium, Ca-ion batteries (CIBs) are an appropriate option to alternate Li-ion batteries (LIBs). A new category of anode materials for CIBs has emerged since the successful synthesis of carbon nanotubes, which are B and N doped derivatives of it. For high-performance CIBs, BC2N nanotube (BC2NNT) has been studied as promising anode materials. In order to comprehend electrochemical attributes, cycling stability, and adsorption behavior of BC2NNT, first-principles computations have been executed. Based on nuclear magnetic resonance computations, two types of hexagonal rings (B2C2N2 (I) and BC4N (II)) were specified that are non-aromatic. Ca has adsorption on B2C2N2 and BC4N with ad
... Show MoreBackground: The highest concentrations of
blood glucose during the day are usually found
postprandialy. Postprandial hyperglycemia (PPH)
is likely to promote or aggravate fasting
hyperglycemia. Evidence in recent years suggests
that PPH may play an important role in functional
& structural disturbances in different body organs
particularly the cardiovascular system.
Objective: To evaluate the effect of (PPH) as a
risk factor for coronary Heart disease in Type 2
diabetic patients.
Methods: Sixty-three type2 diabetic patients
were included in this study. All have controlled
fasting blood glucose, with HbA1c correlation.
They were all followed for five months period
(from May to October 2008)
Solar activity monitoring is important in our life because of its direct or indirect influence on our life, not only on ionospheric communications. To study solar activity, researchers need measuring and monitoring instruments, these instruments are mostly expensive and are not available in all universities. In this paper, a very low frequency radio receiver had been designed and implemented with components available in most markets to support the researchers, college students, and radio astronomy amateurs with a minimum input voltage less than 100µV, an output voltage less than 135 m V with no distortion and an overall gain of 34dB. A comparison had been done between two circuit structures using a workbench software program and experim
... Show MoreThis paper deals with the determination of stresses and deflections of clamped circular diaphragm strengthened by one or two ring-shaped concentric ribs, under uniform static and dynamic pressures. The simulation has been achieved by using the well-known engineering software finite element package MSC/NASTRAN.
As a design study, the effect of using a clamped ring, and the effect of using a ring-shaped rib on both surfaces of diaphragm instead of one, has been discussed in this work. To show the effectiveness of this study, results of this work have been compared with published data [1].
In the conclusion, the authors underline the validity of the&n
... Show More