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.
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This work evaluates the influence of combining twisted fins in a triple-tube heat exchanger utilised for latent heat thermal energy storage (LHTES) in three-dimensional numerical simulation and comparing the outcome with the cases of the straight fins and no fins. The phase change material (PCM) is in the annulus between the inner and the outer tube, these tubes include a cold fluid that flows in the counter current path, to solidify the PCM and release the heat storage energy. The performance of the unit was assessed based on the liquid fraction and temperature profiles as well as solidification and the energy storage rate. This study aims to find suitable and efficient fins number and the optimum values of the Re and the inlet tem
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Background. After tooth extraction, alveolar bone resorption is inevitable. This clinical phenomenon challenges dental surgeons aiming to restore esthetic and function. Alveolar ridge preservation can be applied to minimize dimensional changes with a new socket grafting material, an autogenous dentin graft, produced by mechanically and chemically processing natural teeth. This study assessed the safety and efficacy of using autogenous dentin biomaterial in alveolar ridge preservation. Materials and Methods. Patients with nonrestorable maxillary anterior teeth bounded by natural sound teeth were included in this study. After a detailed clinical and tomographic examination, eligible participants were randomly allocated into two groups
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This study presents a practical method for solving fractional order delay variational problems. The fractional derivative is given in the Caputo sense. The suggested approach is based on the Laplace transform and the shifted Legendre polynomials by approximating the candidate function by the shifted Legendre series with unknown coefficients yet to be determined. The proposed method converts the fractional order delay variational problem into a set of (n ＋ 1) algebraic equations, where the solution to the resultant equation provides us the unknown coefficients of the terminated series that have been utilized to approximate the solution to the considered variational problem. Illustrative examples are given to show that the recommended appro
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A numerical investigation has been performed to study the effect of eccentricity on unsteady state, laminar aiding mixed convection in a horizontal concentric and eccentric cylindrical annulus. The outer cylinder was kept at a constant temperature
while the inner cylinder was heated with constant heat flux. The study involved numerical solution of transient momentum (Navier-Stokes) and energy equation using finite difference method (FDM), where the body fitted coordinate system (BFC) was
used to generate the grid mesh for computational plane. The governing equations were transformed to the vorticity-stream function formula as for momentum equations and to the temperature and stream function for energy equation.
A computer progra
Concerns about the environment, the cost of energy, and safety mean that low-energy cold-mix asphalt materials are very interesting as a potential replacement for present-day hot mix asphalt. The main disadvantage of cold bituminous emulsion mixtures is their poor early life strength, meaning they require a long time to achieve mature strength. This research work aims to study the protentional utilization of waste and by-product materials as a filler in cold emulsion mixtures with mechanical properties comparable to those of traditional hot mix asphalt. Accordingly, cold mix asphalt was prepared to utilize paper sludge ash (PSA) and cement kiln dust (CKD) as a substitution for conventional mineral filler with percentages ranging fro
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In this paper a prey - predator model with harvesting on predator species with infectious disease in prey population only has been proposed and analyzed. Further, in this model, Holling type-IV functional response for the predation of susceptible prey and Lotka-Volterra functional response for the predation of infected prey as well as linear incidence rate for describing the transition of disease are used. Our aim is to study the effect of harvesting and disease on the dynamics of this model.
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