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.
Conventional dosage forms for topical and transdermal drug delivery have several disadvantages related mainly to its poor skin permeation and patient compliance. Many approaches have been developed to improve these dosage forms. Film forming drug delivery systems represents a recent advancement in this field. It provides improved patient compliance with enhanced skin permeation of drugs. In its simplest form, these consist of a polymeric solution, usually in a supersaturated state, in a suitable solvent. A plasticizer is usually added to improve the flexibility and enhance the tensile strength to the film. It is also possible to control and sustain the drug release from the films by controlling the polymeric content, concentration o
... Show MoreAlongside the development of high-speed rail, rail flaw detection is of great importance to ensure railway safety, especially for improving the speed and load of the train. Several conventional inspection methods such as visual, acoustic, and electromagnetic inspection have been introduced in the past. However, these methods have several challenges in terms of detection speed and accuracy. Combined inspection methods have emerged as a promising approach to overcome these limitations. Nondestructive testing (NDT) techniques in conjunction with artificial intelligence approaches have tremendous potential and viability because it is highly possible to improve the detection accuracy which has been proven in various conventional nondestr
... Show MoreUndoubtedly, rutting in asphalt concrete pavement is considered a major dilemma in terms of pavement performance and safety faced by road users as well as the road authorities. Rutting is a bowl-shaped depression in the wheel paths that develop gradually with the increasing number of load applications. Heavy axle loadings besides the high pavement summer temperature enhance the problem of rutting. According to the AASHTO design equation for flexible pavements, a 1.1 in rut depth will reduce the present serviceability index of relatively new pavement, having no other distress, from 4.2 to 2.5. With this amount of drop in serviceability, the entire life of the pavement in effect has been lost. Therefore, it is crucial to look at the mechani
... Show MoreMany pharmaceutical molecules have solubility problems that until yet consist a hurdle that restricts their use in the pharmaceutical preparations. Lacidipine (LCDP) is a calcium-channel blocker with low aqueous solubility and bioavailability.
Lipid dosage forms are attractive delivery systems for such hydrophobic drug molecules. Nanoemulsion (NE) is one of the popular methods that has been used to solve the solubility problems of many drugs. LCDP was formulated as a NE utilizing triacetin as an oil phase, tween 80 and tween 60 as a surfactant and ethanol as a co-surfactant. Nine formulas were prepared, and different tests performed to ensure the stability of the NEs, such as thermodyna
... Show MoreDeaf and dumb peoples are suffering difficulties most of the time in communicating with society. They use sign language to communicate with each other and with normal people. But Normal people find it more difficult to understand the sign language and gestures made by deaf and dumb people. Therefore, many techniques have been employed to tackle this problem by converting the sign language to a text or a voice and vice versa. In recent years, research has progressed steadily in regard to the use of computers to recognize and translate the sign language. This paper reviews significant projects in the field beginning with important steps of sign language translation. These projects can b
The purpose of this paper is to develop a hybrid conceptual model for building information modelling (BIM) adoption in facilities management (FM) through the integration of the technology task fit (TTF) and the unified theory of acceptance and use of technology (UTAUT) theories. The study also aims to identify the influence factors of BIM adoption and usage in FM and identify gaps in the existing literature and to provide a holistic picture of recent research in technology acceptance and adoption in the construction industry and FM sector.
Active worms have posed a major security threat to the Internet, and many research efforts have focused on them. This paper is interested in internet worm that spreads via TCP, which accounts for the majority of internet traffic. It presents an approach that use a hybrid solution between two detection algorithms: behavior base detection and signature base detection to have the features of each of them. The aim of this study is to have a good solution of detecting worm and stealthy worm with the feature of the speed. This proposal was designed in distributed collaborative scheme based on the small-world network model to effectively improve the system performance.
The present study is a linguistic study of comment clauses in the American Series „Friends‟ .Comment clauses refer to those clauses which comment on the content of the main clause or the attitude of the speaker towards the way of speaking .The problem of this study is to answer the following questions ; what types of comment clauses can be used in the face- to –face conversations , for what functions these comment clauses could be used , and how these comment clauses are used by the participants of these conversations . This study is a qualitative one . The study aims to investigate the types of comment clauses used in the American Series “Friends‟. The study also aims to investigate the pragmatic functions of these comment clause
... Show MoreThe history of the Olympic movement in Iraq is a rich history that reflects the interest of Iraqi governments and society in sports, the social and economic conditions, and international relations, and highlights the intersection of sports and politics and the impact of global events on local sports development. Therefore, providing a valuable insight into the reality of the participation and results achieved by Iraq in the Olympic Games for the period under study helps in giving a broader understanding of Iraq’s position in the global sports community. The research aims to document the important events in the development of the Olympic movement in Iraq for the period (1929-2000) and explore the formation and development of the Iraqi Olym
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