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 present paper attempts to detect the level of (COVID-19) pandemic panic attacks among university students, according to gender and stage variables.
To achieve this objective, the present paper adopts the scale set up by (Fathallah et al., 2021), which has been applied electronically to a previous cross-cultural sample consisting of (2285) participants from Arab countries, including Iraq. The scale includes, in its final form, (69) optional items distributed on (6) dimensions: physical symptoms (13) items, psychological and emotional symptoms (12) items, cognitive and mental symptoms (11) items, social symptoms (8) items, general symptoms (13) items and daily living practices (12) items
... Show MoreAn experimental and numerical study has been carried out to investigate the forced convection heat transfer by clean or dusty air in a two dimensional annulus enclosure filled with porous media (glass beads) between two vertical concentric cylinders. The outer cylinder is of (82 mm) outside diameters and the inner cylinder of (27 mm) outside diameter. Under steady state condition; the inner cylinder surface is maintained at a high temperature by applying a uniform heat flux and the outer cylinder surface at an ambient temperature. The investigation covered values of input power of (6.3, 4.884, 4.04 and 3.26 W), Reynolds number values of (300, 700, 1000, 1500, and 2000) and dust ratio values (density number N) of (2, 4, 6 and 8). A comput
... Show MoreIn this paper, an analytical solution describing the deflection of a cracked beam repaired with piezoelectric patch is introduced. The solution is derived using perturbation method. A novel analytical model to calculate the proper dimensions of piezoelectric patches used to repair cracked beams is also introduced. This model shows that the thickness of the piezoelectric patch depends mainly on the thickness of the cracked beam, the electro-mechanical properties of the patch material, the applied load and the crack location. Furthermore, the model shows that the length of the piezoelectric patches depends on the thickness of the patch as well as it depends on the length of the cracked beam and the crack depth. The additional flexibil
... Show MoreABSTRACT Background: Blood donation is process obtaining, analyzing, preparing, and preserving blood and its many components essential for life-saving that enhances health and lowers mortality rates. Despite the fact that giving blood is frequently demonstrated to be a voluntary service, certain studies highlight a number of factors that affect blood donations such as Gender, past donor experiences including syncopal reactions, venipuncture pain, anxiety, and donor satisfaction, all have an impact on the decision to donate blood.in addition, one of the main reasons donors reject to donate blood is pain associated with venipuncture. Aim: Evaluate the effectiveness of shotblocker on pain during venipuncture in adult blood donors compared to
... Show MoreCognitive stylistics also well-known as cognitive poetics is a cognitive approach to language. This study aims at examining literary language by showing how Schema Theory and Text World Theory can be useful in the interpretation of literary texts. Further, the study attempts to uncover how readers can connect between the text world and the real world. Putting it differently, the study aims at showing how the interaction between ‘discourse world’ and ‘text world’. How readers can bring their own experience as well as their background knowledge to interact with the text and make interpretive connections.
Schema and text world theories are useful tools in cognitive stylistic stud
... Show MoreThe sustainable development according to the United Nation, listed firms throughout globally now routinely provide sustainability data. However, there is not enough information on Sustainability Performance Quality (SPQ) in the majority of emerging economies, including Malaysia. This study looks at how the SPQ of the top 100 Malaysian-listed businesses is affected by factors as connected with corporate governance (e.g., board meeting, board size, and board ethnic diversity). Utilizing 500 firm-year data, a longitudinal sample of 500 nonfinancial firms on the Bursa Malaysia for 2015-2019 is employed in this study. The findings from the analysis using the panel regression demonstrated that: ethnic diversity and board siz
... Show MoreRecent years have witnessed an increase in the use of composite coatings for numerous applications, including aerospace, aircraft, and maritime vessels. These materials owe this popularity surge to the superior strength, weight, stiffness, and electrical insulation they exhibit over conventional substances, such as metals. The growing demand for such materials is accompanied by the inevitable need for fast, accurate, and affordable nondestructive testing techniques to reveal any possible defects within the coatings or any defects under coating. However, typical nondestructive testing (NDT) techniques such as ultrasonic testing (UT), infrared thermography (IRT), eddy current testing (ECT), and laser shearography (LS) have failed to p
... Show MoreA new modified differential evolution algorithm DE-BEA, is proposed to improve the reliability of the standard DE/current-to-rand/1/bin by implementing a new mutation scheme inspired by the bacterial evolutionary algorithm (BEA). The crossover and the selection schemes of the DE method are also modified to fit the new DE-BEA mechanism. The new scheme diversifies the population by applying to all the individuals a segment based scheme that generates multiple copies (clones) from each individual one-by-one and applies the BEA segment-wise mechanism. These new steps are embedded in the DE/current-to-rand/bin scheme. The performance of the new algorithm has been compared with several DE variants over eighteen benchmark functions including sever
... Show More