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 paper proposes a new approach to model and analyze erect posture, based on a spherical inverted pendulum which is used to mimic the body posture. The pendulum oscillates in two directions, [Formula: see text] and [Formula: see text], from which the mathematical model was derived and two torque components in oscillation directions were introduced. They are estimated using stabilometric data acquired by a foot pressure mapping system. The model was quantitatively investigated using data from 19 participants, who were first were classified into three groups, according to the foot arch-index. Stabilometric data were then collected and fed into the model to estimate the torque’s components. The components were statistically proce
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The aim of the present research is to study different protein fractions in sera of children and adolescent with β –thalassemia major and minor and to compare the results with that of healthy control.One hundred fifty children and adolescents were enrolled in this study,including 50 patients with β- thalassemia major , 50 patients with β- thalassemia minor as pathological control group and another apparently 50 healthy individuals as a control group. The age of all studied groups ranged from (4-18)years.Total protein, albumin and immunoglobulins were estimated in sera of all subjects. A Significant decrease was found in the total protein and albumin&nb
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The aerodynamic characteristics of the forward swept wing aircraft have been studied theoretically and experimentally. Low order panel method with the Dirichlet boundary condition have been used to solve the case of the steady, inviscid and compressible flow. Experimentally, a model was manufactured from wood to carry out the tests. The primary objective of the experimental work was the measurements of the wake dimensions and orientation, velocity defect along the wake and the wake thickness. A blower type low speed (open jet) wind tunnel was used in the experimental work. The mean velocity at the test section was (9.3 m/s) and the Reynolds number based on the mean aerodynamic chord and the mean velocity was (0.46x105). The measurements sho
... Show MoreThis research is an attempt to explore a social and pragmatic phenomenon of lamentation in elegies of Gray and AL-Khansaa' who represent two different cultures. It illustrates the intended meaning of lamentation in English and Arabic and finds how the two languages express this purpose of poetry by analysing it socio-pragmatically adopting Searle's models (1969),and its modifications. Lamentation is considered as a mournful poem lamenting the death of whole humanity as Gray's elegy and of an individual as AL-Khansaa's elegy. So, Gray portrays a universal picture concerning his lamentation, while AL-Khansaa' portrays an individual and subjective picture regarding her lamentation. As branches of linguistics, sociolinguistics de
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According to the famous saying of the medieval physician Paracelsus, "There is no substance without poison. Only the dose determines the extent of the toxic effect." Here, the effect of monosodium glutamate (MSG) on human health and the risks to the health of its frequent use in the short term was addressed and the long term was evaluated according to the studies of several researchers specializing in this regard. Monosodium glutamate (MSG) is known as one of the most popular food additives that classified as a flavor enhancer. Parts of the evidence were reviewed from the literature explaining its effect on immune system cells in addition to metabolic disorders by exposing individuals to obesity and what is known as metabolic syndrome, as w
... Show MoreThe research is exposed to the concept of rough discourse in contemporary theater with a critical reading that takes the genealogical work as a starting point in deconstructing the references of rough discourse and pursuing its paths in the civilization and cultural framework and how it identifies aesthetically within the theatrical field and the extents of its procedural treatments in order to reveal it and clarify its limits and representations, as the research included the first chapter. (methodological framework), the second chapter (theoretical framework), which included two sections, the first took place under the title (rough dramatization), while the second topic took place under the title (rough drama), and the second chapter re
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