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.
A ‘locking-bolt’ demountable shear connector (LBDSC) is proposed to facilitate the deconstruction and reuse of steel-concrete composite structures, in line with achieving a more sustainable construction design paradigm. The LBDSC is comprised of a grout-filled steel tube and a geometrically compatible partially threaded bolt. The latter has a geometry that ‘locks’ the bolt in compatible holes predrilled on the steel flange and eliminates initial slip and construction tolerance issues. The structural behaviour of the LBDSC is evaluated through nine pushout tests using a horizontal test setup. The effects of the tube thickness, strength of concrete slab, and strength of infilled grout on the shear resistance, initial stiffness, and du
... Show MoreRheumatoid arthritis is a chronic, progressive, inflammatory autoimmune disease of unidentified etiology, associated with articular, extra-articular and systemic manifestation that require long-standing treatment. Taking patient’s beliefs about the prescribed medication in consideration had been shown to be an essential factor that affects adherence of the patient in whom having positive beliefs is an essential for better adherence. The purpose of the current study was to measure beliefs about medicines among a sample of Iraqi patients with Rheumatoid arthritis and to determine possible association between this belief and some patient-certain factors. This study is a cross-sectional study carried out on 250 already diagnosed rheumatoid
... Show MoreUnderstanding, promoting, and teaching media literacy is an important societal challenge. STEM educators are increasingly looking to incorporate 21st century skills such as media literacy into core subject education. In this paper we investigate how undergraduate Computer Science (CS) students can learn media literacy as a by-product of collaborative video tutorial production. The paper presents a study of 34 third-year CS undergraduates who, as part of their learning, were each asked to produce three video tutorials on Raspberry Pi programming, using a collaborative video production tool for mobile phones (Bootlegger). We provide results of both quantitative and qualitative analysis of the production process and resulting video tutorials,
... Show Moreplanning is among the most significant in the field of robotics research. As it is linked to finding a safe and efficient route in a cluttered environment for wheeled mobile robots and is considered a significant prerequisite for any such mobile robot project to be a success. This paper proposes the optimal path planning of the wheeled mobile robot with collision avoidance by using an algorithm called grey wolf optimization (GWO) as a method for finding the shortest and safe. The research goals in this study for identify the best path while taking into account the effect of the number of obstacles and design parameters on performance for the algorithm to find the best path. The simulations are run in the MATLAB environment to test the
... Show MoreA substantial portion of today’s multimedia data exists in the form of unstructured text. However, the unstructured nature of text poses a significant task in meeting users’ information requirements. Text classification (TC) has been extensively employed in text mining to facilitate multimedia data processing. However, accurately categorizing texts becomes challenging due to the increasing presence of non-informative features within the corpus. Several reviews on TC, encompassing various feature selection (FS) approaches to eliminate non-informative features, have been previously published. However, these reviews do not adequately cover the recently explored approaches to TC problem-solving utilizing FS, such as optimization techniques.
... Show MoreHomomorphic encryption became popular and powerful cryptographic primitive for various cloud computing applications. In the recent decades several developments has been made. Few schemes based on coding theory have been proposed but none of them support unlimited operations with security. We propose a modified Reed-Muller Code based symmetric key fully homomorphic encryption to improve its security by using message expansion technique. Message expansion with prepended random fixed length string provides one-to-many mapping between message and codeword, thus one-to many mapping between plaintext and ciphertext. The proposed scheme supports both (MOD 2) additive and multiplication operations unlimitedly. We make an effort to prove
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