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.
The conjunctive ''and'' and its Arabic counterpart ''و'' are discourse markers that express certain meanings and presuppose the presence of other elements in discourse. They are indispensable aids to both the text writers and readers. The present study aims to show that such cohesive ties help the writer to organize his main argument and communicate his ideas vividly and smoothly. They also serve as explicit signals that help readers unfold text and follow its threads as realized in the progression of context. The researcher has utilized the Quirk Model of Semantic Implication for data analysis. A total of 42 (22 for English and 20 for Arabic) political texts selected from different elite newspapers in both Arabic and English for the analy
... Show MoreThis work represents development and implementation a programmable model for evaluating pumping technique and spectroscopic properties of solid state laser, as well as designing and constructing a suitable software program to simulate this techniques . A study of a new approach for Diode Pumped Solid State Laser systems (DPSSL), to build the optimum path technology and to manufacture a new solid state laser gain medium. From this model the threshold input power, output power optimum transmission, slop efficiency and available power were predicted. different systems configuration of diode pumped solid state laser for side pumping, end pump method using different shape type (rod,slab,disk) three main parameters are (energy transfer efficie
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This study attempts to provide an approach analysis for the news, depending on the bases and principles which conceptuality semiotic researchers of this field first of them «A. J. Gremas» for the theory of «narrative discourse analysis», to more clarify we tried to apply it on a published press- news, to concludes the most important steps and methods that are necessary to follows gain more understanding of the press- news.
In this work a chemical sensor was built by using Plane Wave Expansion (PWE) modeling technique by filling the core of 1550 hollow core photonic crystal fiber with chloroform that has different concentrations after being diluted with distilled water. The minimum photonic bandgap width is.0003 and .0005 rad/sec with 19 and 7 cells respectively and a concentration of chloroform that filled these two fibers is 75%.
The Internet of Things (IoT) technology is every object around us and it is used to connect these objects to the Internet to verify Machine to Machine (M2M) communication. The smart house system is the most important application of IoT technology; it is increase the quality of life and decrease the efforts. There were many problems that faced the existing smart house networking systems, including the high cost of implementation and upgrading, high power consumption, and supported limited features. Therefore, this paper presents the design and implementation of smart house network system (SHNS) using Raspberry Pi and Arduino platforms as network infrastructure with ZigBee technology as wireless communication. SHNS consists of two mai
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In this paper, the first integrals of Darboux type of the generalized Sprott ET9 chaotic system will be studied. This study showed that the system has no polynomial, rational, analytic and Darboux first integrals for any value of . All the Darboux polynomials for this system were derived together with its exponential factors. Using the weight homogenous polynomials helped us prove the process.
Objective: To review and identify the major drivers for COVID-19 vaccine acceptance. Methods: A scoping review of studies of COVID-19 vaccine perceptions and barriers to using the COVID-19 vaccines. Two search engines, including PubMed and Google Scholar, were purposefully searched. Results: Eight studies from different countries were reviewed to categorize factors influencing people's acceptance of COVID-19 according to the Health Belief Model (HBM). Perceived susceptibility, and severity of the disease (COVID-19), in addition to perceived benefits of COVID-19 vaccination and "cues to action", can enhance vaccination acceptance. In contrast, perceived barriers to the COVID-19 vaccine can increase people's hesitancy to be vaccinated
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