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.
One of the most essential components of asphalt pavements is the filler. It serves two purposes. First, this fine-grained material (diameter less than 0.075 mm) improves the cohesiveness of aggregate with bitumen. Second, produce a dense mixture by filling the voids between the particles. Aluminum dross (AD), which is a by-product of aluminum re-melting, is formed all over the world. This material causes damage to humans and the environment; stockpiling AD in landfills is not the best solution. This research studies the possibility of replacing part of the conventional filler with aluminum dross. Three percent of dross was used, 10, 20, and 30% by filler weight. The MarshallMix design method was adopted to obtain the op
... Show More
(2)
To date, comprehensive reviews and discussions of the strengths and limitations of Remote Sensing (RS) standalone and combination approaches, and Deep Learning (DL)-based RS datasets in archaeology have been limited. The objective of this paper is, therefore, to review and critically discuss existing studies that have applied these advanced approaches in archaeology, with a specific focus on digital preservation and object detection. RS standalone approaches including range-based and image-based modelling (e.g., laser scanning and SfM photogrammetry) have several disadvantages in terms of spatial resolution, penetrations, textures, colours, and accuracy. These limitations have led some archaeological studies to fuse/integrate multip
... Show More
(20)
(17)
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 More
(46)
(43)
(57)
(61)
(1)
(1)
(163)
(167)
Rheumatoid 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 More
(15)
(14)
(167)
Understanding, 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 More
(20)
(17)
planning 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 More
(6)
(4)