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 aims to analyze a three-dimensional discrete-time biological system, a prey-predator model with a constant harvesting amount. The stage structure lies in the predator species. This analysis is done by finding all possible equilibria and investigating their stability. In order to get an optimal harvesting strategy, we suppose that harvesting is to be a non-constant rate. Finally, numerical simulations are given to confirm the outcome of mathematical analysis.
This study deals with the concepts of Colonialism and Civilization in Aimé Cesaire’s A Tempest. The concern of this study is to discuss how postcolonial writers are continually re-writing the Western canonical works as a reaction to the European cultural hegemony. The Western representations of the black are products of specific moments and developments in history and culture. A Tempest reflects a certain historical moment in the decolonization process.
A Tempest is analysed to reveal the counter literary strategy used by Aimé Cesaire, and to disclose the reasons why re-writing and writing back are considered as vital and inescapable tasks. Shakespeare’s The Tempest, which deals with the
... Show MoreCandida is the scientific name for yeast. It is a fungus that lives almost everywhere, including in human body. Usually, the immune system keeps yeast under control. If the individual is sick or taking antibiotics, it can multiply and cause an infection. Yeast infections affect different parts of the body in different ways including thrush is a yeast infection that causes white patches in oral cavity ,Candida esophagitis is thrush that spreads to esophagus, women can get vaginal yeast infections,(vaginitis) causing itchiness, pain and discharge, yeast infections of the skin cause itching and rashes ,yeast infections in bloodstream can be life-threatening . The current review article will concentrate on vaginal infection (vaginitis), project
... Show MoreWorldwide, enormous amounts of waste cause major environmental issues, including scrap tires and plastic, and large waste, a consequence of the demolition of buildings, including crushed concrete, crushed clay bricks, and crushed thermo-stone. From that point, it’s possible to consider that the recycling processes for these materials and using them in the manufacturing field will reduce the adverse effects on the environment of these wastes and the consumption of natural resources. Sustainable concrete blocks can be considered as one of the products produced by using these materials as partial volume replacement of the coarse, fine aggregate, or cement content, considering their dry density, workability, absorption, co
... Show MoreConstruction projects are characterized as projects with multi phases and activities, complex, unique, and have many different parties and stakeholders. Risks could appear at one or more of the construction project stages and may affect the achievement of project objectives. Therefore, one of the key elements in the planning phase of any project is the risk management process (RMP). This study attempts to understand the terminology of risk in general, risk management, and response to risk in particular. This study is mainly a review of thirty-eight studies that have been published between 1997 and 2020 that demonstrate the importance of the crucial phase of risk response from the risk management process and its impact on
... Show MoreIn the current paradigms of information technology, cloud computing is the most essential kind of computer service. It satisfies the need for high-volume customers, flexible computing capabilities for a range of applications like as database archiving and business analytics, and the requirement for extra computer resources to provide a financial value for cloud providers. The purpose of this investigation is to assess the viability of doing data audits remotely inside a cloud computing setting. There includes discussion of the theory behind cloud computing and distributed storage systems, as well as the method of remote data auditing. In this research, it is mentioned to safeguard the data that is outsourced and stored in cloud serv
... Show MoreObjective: Geographic differences in clinical and pathological aspects of ameloblastoma have been suggested, therefore the purpose of this study was to analyze cases of ameloblastoma in terms of clinical and radiographic manifestations, histopathological types, treatment modalities and recurrence rate and compare them with reports from other parts of the world. Methods: The medical reports of patients diagnosed with ameloblastoma were reviewed and the data concerning the age, gender, chief complaint, the anatomical site of the lesion, radiographic appearance, histopathological diagnosis, treatment approach and recurrence were retrieved. Surgical treatment consisted of either enucleation with curettage and peripheral ostectomy or resection;
... Show MoreVirtual organization is similar to traditional organization in principles, but is different in the ways it operates. It requires small creation costs compared to the traditional and it uses electronic commerce as the market place and distribution channel for its products and services.The aim of this article is to applying electronic commerce for a proposed virtual organization. The tools used to build an effective web application for virtual organization to provide virtual environment to the customers to do the transaction activities online include PHP, MySQL and Apache. HTML is used for displaying forms and tables and JavaScript is used for verification in client side. Finally, connecting it to 2Checkout.com company as a third party to per
... Show More