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 The aim of this paper is to shed light on the theme of Gender Struggle and Women’s Predicament in Tennessee Williams’ A Street Car Named Desire .The paper tries to show William's dealings with the critical social themes like Men's Brutality and women's predicament. The paper exposes the complete shift of the balance of power between the genders in America after the two world wars. Williams illustrates society’s changing attitudes towards masculinity and denounces the society's attitudes towards women in America at that time. He rebels against the cruelty of the modern age and regrets the disintegration of the values of the south and their being replaced by the disruptive forces of modern life. In the end of the play, brutalit
... Show MoreAlizarin is one of the popularly used and wide separated compounds with a chemical name (1,2- dihydroxy-9,10-anthraquinone) which belong to the anthraquinones family that contain three aromatic conjugated rings and in the central rings it contains two ketonic groups.1
Background: Radiopacity is one of the prerequisites for dental materials, especially for composite restorations. It's essential for easy detection of secondary dental caries as well as observation of the radiographic interface between the materials and tooth structure. The aim of this study to assess the difference in radiopacity of different resin composites using a digital x-ray system. Materials and methods: Ten specimens (6mm diameter and 1mm thickness) of three types of composite resins (Evetric, Estelite Sigma Quick,and G-aenial) were fabricated using Teflon mold. The radiopacity was assessed using dental radiography equipment in combination with a phosphor plate digital system and a grey scale value aluminum step wedge with thickness
... Show MoreProducts’ quality inspection is an important stage in every production route, in which the quality of the produced goods is estimated and compared with the desired specifications. With traditional inspection, the process rely on manual methods that generates various costs and large time consumption. On the contrary, today’s inspection systems that use modern techniques like computer vision, are more accurate and efficient. However, the amount of work needed to build a computer vision system based on classic techniques is relatively large, due to the issue of manually selecting and extracting features from digital images, which also produces labor costs for the system engineers. In this research, we pr
... Show MoreThis encapsulates the general relationship between plant and bacteria in the natural and agricultural ecosystem. It is based on the activities of useful bacteria, such as plant growth-promoting bacteria (PGPRs) and nitrogen-fixing bacteria, in promoting plant growth and plant tolerance to stressful situations regarding pollution, salinity, and drought. The article also mentions that the bacteria maintain plant health by secretion of phytohormones, nitrogen fixation, solubilization of phosphate, and production of antibiotics against pathogenic bacteria. The article also mentions the existing applications of the interaction in sustainable agriculture and bioremediation of contaminated soils.
he study aims to build a model that revolves around the main question of the role of strategic agility (SA) in enhancing organizational excellence (OE). For the purpose of achieving OE and to determine the extent of interest and knowledge of managers at the Midwest Refineries Company (MRC) on the theoretical and practical implications, and on the performance foundations of these two vital variables with the aim of continuous improvement. A questionnaire was used and distributed to a random sample of 54 managers in this important energy production company. The study followed the descriptive analytical approach to answer the questions raised. The study model and dimensions were built according to reference models, most notably the models (Al-
... Show MoreMalicious software (malware) performs a malicious function that compromising a computer system’s security. Many methods have been developed to improve the security of the computer system resources, among them the use of firewall, encryption, and Intrusion Detection System (IDS). IDS can detect newly unrecognized attack attempt and raising an early alarm to inform the system about this suspicious intrusion attempt. This paper proposed a hybrid IDS for detection intrusion, especially malware, with considering network packet and host features. The hybrid IDS designed using Data Mining (DM) classification methods that for its ability to detect new, previously unseen intrusions accurately and automatically. It uses both anomaly and misuse dete
... Show MoreThis study deals with an important area in the field of linguistics, namely person deixis.
The study aims at: (1) Describing the notion of deixis, its importance, and its place in the field
of linguistics, (2) Presenting a detailed illustration of person deixis, and (3) Conducting an
analysis of person deixis in one of Synge‟s plays Riders to The Sea according to Levinson‟s
model. The most important aim of these three is the third one (the analysis). To achieve this
aim, the researcher depends on Levinson‟s (1983) descriptive approach. According to the
descriptive approach of deixis, the category of person deixis can be defined as the encoding of
the participant roles in the speech situation. This encoding is r
A new, easy‐to‐manufacture, and low‐cost integrated cubical solar collector tank for domestic usage is concerned in this work. Three models are prepared, side by side, and tested to point out their seasonal performance. Tank Model I has three vertical sides, black painted and glazed to act as an absorber; the other sides are insulated. Tank Model II has two black painted and glazed sides, with four insulated surfaces. The models are south‐oriented at different positions and tested versus the conventional tank (Model III) to validate and assess their performance in summer and winter. In summer, the temperatures in Models I and II are lower than those for Model III since they have insulated sid