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 is devoted to an inverse problem of determining discontinuous space-wise dependent heat source in a linear parabolic equation from the measurements at the final moment. In the existing literature, a considerably accurate solution to the inverse problems with an unknown space-wise dependent heat source is impossible without introducing any type of regularization method but here we have to determine the unknown discontinuous space-wise dependent heat source accurately using the Haar wavelet collocation method (HWCM) without applying the regularization technique. This HWCM is based on finite-difference and Haar wavelets approximation to the inverse problem. In contrast to othe
This study examined the imperative construction: the command, the interrogative, the prohibition, the call, and the wish. In the Diwan of Al-Shamakh bin Dirar; where the poetic verses were monitored in each of the topics of the student's creation, and the rhetorical meanings that he came out with. What is new in this study is that it is the first to study the demanded composition in the poetry of a glorious poet, Al-Shammakh bin Dirar Al-Dhubyani. As his poetry did not receive such a study, it sought to employ what was written by rhetoric scholars, in an attempt to explore the demanded composition in the poetry of Al-Shamakh. The study adopted the descriptive analytical approach, which is based on counting the number of times the poet us
... Show MoreThe hydrodynamics behavior of gas - solid fluidized beds is complex and it should be analyzed and understood due to its importance in the design and operating of the units. The effect of column inside diameter and static bed height on the minimum fluidization velocity, minimum bubbling velocity, fluidization index, minimum slugging velocity and slug index have been studied experimentally and theoretically for three cylindrical columns of 0.0762, 0.15 and 0.18 m inside diameters and 0.05, 0.07 and 0.09 m static bed heights .The experimental results showed that the minimum fluidization and bubbling velocities had a direct relation with column diameter and static bed height .The minimum slugging velocity had an
... Show MoreThis study deals with the time property in the cinema through two films: (The Knife) directed by Khalid Hamada and (The Deceived) directed by Tawfiq Saleh. These two films were excerpted by the cinema from two novels of the Palestinian writer Ghassan Kanafani, the first is from the novel (What is Left for You) and the second is from the novel (Men in the Sun). If the Palestinian novel has imposed its presence on the Arab creative scene through a group of novelists who took it upon themselves to communicate their cause to the world, the Palestinian cinema has been far from being a purely Palestinian, because many of the cinematic works have been provided by Arab countries on the issue, while this cinema is still seeking
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The subject of this research is the study of the formal alienation of contemporary English sculpture, by comparing the most important sculptors of the new contemporary generation. This research problem is to look for the important factors in the formation of the contemporary sculptural structure of the exotic, and what is the mechanism of formation and output of these forms. The research seeks to explore (Alienation in contemporary sculpture between the works of Anthony Caro and Tony Cragg) in a comparative study. The importance of the research is to identify the concept of alien forms in contemporary British sculpture, especially in the cases of Anthony Caro and Tony Cragg that this research is considered a know
Vehicular Ad Hoc Networks (VANETs) are integral to Intelligent Transportation Systems (ITS), enabling real-time communication between vehicles and infrastructure to enhance traffic flow, road safety, and passenger experience. However, the open and dynamic nature of VANETs presents significant privacy and security challenges, including data eavesdropping, message manipulation, and unauthorized access. This study addresses these concerns by leveraging advancements in Fog Computing (FC), which offers lowlatency, distributed data processing near-end devices to enhance the resilience and security of VANET communications. The paper comprehensively analyzes the security frameworks for fog-enabled VANETs, introducing a novel taxonomy that c
... Show MoreBackground: The healing process involves the restoration of the body’s structural integrity. The extracellular matrix, blood cells, cytokines, and growth factors are all involved in this dynamic, intricate, multicellular process. Hemostasis, the inflammatory phase, the proliferative phase, and the maturation phase are all included. Opuntia ficus-indica oil (OFI) and Punica grantum (PGS) oil are extensively used natural treatments that are regarded as advantageous for their sedative, spasmolytic, and anti-inflammatory properties, as well as for angiogenesis promotion, fibroblast increase, collagen production and deposition, and extracellular-matrix remodeling. Materials and methods: Twenty-four New Zealand rab
... Show MoreStereo lithography (SLA) three-dimensional (3D) printing process is a type of additive manufacturing techniques that uses digital models from computer-aided design to automatically produce customized 3D objects. Around 30 years, it has been widely utilized in the manufacturing, design, engineering, industrial sectors and its applications in dentistry for manufacturing prosthodontics are very important. The stereo lithography technology is highly regarded because it can produce items with excellent precision especially when selecting the best process parameters. This review article offers a useful and scientific summary of SLA three-dimensional printing technology and its brief history. The specific type of 3D printers which is SLA type b
... Show MoreIn this work, an efficient energy management (EEM) approach is proposed to merge IoT technology to enhance electric smart meters by working together to satisfy the best result of the electricity customer's consumption. This proposed system is called an integrated Internet of things for electrical smart meter (2IOT-ESM) architecture. The electric smart meter (ESM) is the first and most important technique used to measure the active power, current, and energy consumption for the house’s loads. At the same time, the effectiveness of this work includes equipping ESM with an additional storage capacity that ensures that the measurements are not lost in the event of a failure or sudden outage in WiFi network. Then then these
... Show MoreIn this paper a prey-predator-scavenger food web model is proposed and studied. It is assumed that the model considered the effect of harvesting and all the species are infected by some toxicants released by some other species. The stability analysis of all possible equilibrium points is discussed. The persistence conditions of the system are established. The occurrence of local bifurcation around the equilibrium points is investigated. Numerical simulation is used and the obtained solution curves are drawn to illustrate the results of the model. Finally, the nonexistence of periodic dynamics is discussed analytically as well as numerically.