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.
This work proposes a new video buffer framework (VBF) to acquire a favorable quality of experience (QoE) for video streaming in cellular networks. The proposed framework consists of three main parts: client selection algorithm, categorization method, and distribution mechanism. The client selection algorithm was named independent client selection algorithm (ICSA), which is proposed to select the best clients who have less interfering effects on video quality and recognize the clients’ urgency based on buffer occupancy level. In the categorization method, each frame in the video buffer is given a specific number for better estimation of the playout outage probability, so it can efficiently handle so many frames from different video
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Abstract
People are supposed to use language harmoniously and compatibly. However, aggression may characterize much of human communication. Aggression has long been recognized as a negative anti-social issue that prevails in most personal interactions. If it abounds in familial communications, it is more dangerous due to its harmful effects on individuals, and consequently on societies. Aggression refers to all the instances in which we try to get our way without any consideration for others. Moriarty’s novel (2014), Big Little Lies, is argued to represent the patterns of aggressive communications. This study aims to find out the motivations behind aggressive language in familial communication in this
... Show MoreNotes are given regarding new record species of the braconid parasite short note in Iraq. That is Apanteles angalcti it is found to parasitize early larval instaxs of Ectomyslois ceratontae, one of the most serious pests of pomegra- nate fruit.
In this paper, a modified derivation has been introduced to analyze the construction of C-space. The profit from using C-space is to make the process of path planning more safety and easer. After getting the C-space construction and map for two-link planar robot arm, which include all the possible situations of collision between robot parts and obstacle(s), the A* algorithm, which is usually used to find a heuristic path on Cartesian W-space, has been used to find a heuristic path on C-space map. Several modifications are needed to apply the methodology for a manipulator with degrees of freedom more than two. The results of C-space map, which are derived by the modified analysis, prove the accuracy of the overall C-space mapping and cons
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Orbital varices are vein dilations in the orbit presenting various symptoms. This scoping review synthesizes existing evidence on their epidemiology, clinical features, and treatment efficacy.
Literature was reviewed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. PubMed and Scopus were searched until April 31, 2024, for articles on clinically diagnosed ocular varices detailing diagnostic methods, treatments, and outcomes. Exclusions were reviews, animal studies, and incomplete case reports. Data on study characteristics, diagnosis, management, and o
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Groundwater modelling is particularly challenging in arid regions where limited water recharge is available. A fault zone will add a significant challenge to the modelling process. The Western Desert in Iraq has been chosen to implement the modelling concept and calculate the model sensitivity to the changes in aquifer hydraulic properties and calibration by researching 102 observations and irrigation wells. MODFLOW-NWT, which is a Newtonian formulation for MODFLOW-2005 approaches, have been used in this study. Further, the simulation run has been implemented using the Upstream-Weighting package (UPW) to treat the dry cells. The results show sensitivity to the change of the Kx value for the major groundwater discharge flow. Only abo
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The objective of this review was to describe the COVID-19 complications after recovery.
The researchers systematically reviewed studies that reported post-COVID-19 complications from three databases: PubMed, Google Scholar and the World Health Organization (WHO) COVID-19 database. The search was conducted between 21 November 2020 and 14 January 2021. Inclusion criteria were articles written in English, with primary data, reporting complications of COVID-19 after full
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The aerodynamic characteristics of general three-dimensional rectangular wings are considered using non-linear interaction between two-dimensional viscous-inviscid panel method and vortex ring method. The potential flow of a two-dimensional airfoil by the pioneering Hess & Smith method was used with viscous laminar, transition and turbulent boundary layer to solve flow about complex configuration of airfoils including stalling effect. Viterna method was used to extend the aerodynamic characteristics of the specified airfoil to high angles of attacks. A modified vortex ring method was used to find the circulation values along span wise direction of the wing and then interacted with sectional circulation obtained by Kutta-Joukowsky the
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