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.
Polarization manipulation elements operating at visible wavelengths represent a critical component of quantum communication sub-systems, equivalent to their telecom wavelength counterparts. The method proposed involves rotating the optic axis of the polarized input light by an angle of 45 degree, thereby converting the fundamental transverse electric (TE0) mode to the fundamental transverse magnetic (TM0) mode. This paper outlines an integrated gallium phosphide-waveguide polarization rotator, which relies on the rotation of a horizontal slot by 45 degree at a wavelength of 700 nm. This will ultimately lead to the conception of a mode hybridization phenomeno
This study was done to evaluate a new technique to determine the presence of methamphetamine in the hair using nano bentonite-based adsorbent as the filler of extraction column. The state of the art of this study was based on the presence of silica in the nano bentonite that was assumed can interact with methamphetamine. The hair used was treated using methanol to extract the presence of methamphetamine, then it was continued by sonicating the hair sample. Qualitative analysis using Marquish reagent was performed to confirm the presence of methamphetamine in the isolate.The hair sample that has been taken in a different period confirmed that this current developing method can be used to analyzed methamphetamine. This m
... Show MoreSince the Internet has been more widely used and more people have access to multimedia content, copyright hacking, and piracy have risen. By the use of watermarking techniques, security, asset protection, and authentication have all been made possible. In this paper, a comparison between fragile and robust watermarking techniques has been presented to benefit them in recent studies to increase the level of security of critical media. A new technique has been suggested when adding an embedded value (129) to each pixel of the cover image and representing it as a key to thwart the attacker, increase security, rise imperceptibility, and make the system faster in detecting the tamper from unauthorized users. Using the two watermarking ty
... Show MorePolarization manipulation elements operating at visible wavelengths represent a critical component of quantum communication sub-systems, equivalent to their telecom wavelength counterparts. The method proposed involves rotating the optic axis of the polarized input light by an angle of 45 degree, thereby converting the fundamental transverse electric (TE0) mode to the fundamental transverse magnetic (TM0) mode. This paper outlines an integrated gallium phosphide-waveguide polarization rotator, which relies on the rotation of a horizontal slot by 45 degree at a wavelength of 700 nm. This will ultimately lead to the conception of a mode hybridization phenomenon in the waveguide. The simulation results demonstrate a polarization co
... Show MoreThe melting duration in the photovoltaic/phase-change material (PV/PCM) system is a crucial parameter for thermal energy management such that its improvement can realize better energy management in respect to thermal storage capabilities, thermal conditions, and the lifespan of PV modules. An innovative and efficient technique for improving the melting duration is the inclusion of an exterior metal foam layer in the PV/PCM system. For detailed investigations of utilizing different metal foam configurations in terms of their convective heat transfer coefficients, the present paper proposes a newly developed mathematical model for the PV/PCM–metal foam assembly that can readily be implemented with a wide range of operating condition
... Show MoreThe Rwandan author of comfort chests and verse pleasure of the most important historians of the Seljuks in the sixth century AH / twelfth century and belongs to the mostly ethnic scientists family has won favor with the Sultans of the Seljuks until he became the most famous Markhém is his main source of research sources with respect to the political and social history the Seljuks and the relationship of the Seljuk sultans of the Abbasid caliphs in Baghdad.
The book included the history of the Seljuks from the time of statehood in the fifth century AH / atheist century AD until the death of the Sultan Tgrl bin Arslan year 590 AH / 1193 AD and then shed Akhawarzmeyen, and touched the author at the end of the book in separate chapters t
This study is concerned with the concept of offering a point of view as a narrative construction element, especially the element and point of view of the novel to the letter Alcinmatugrave both business taken from masterpieces and literary works in the foundation or set of cinema. On the whole, the narrator participate in mock narrative process and support the narrator visual image, especially stories that need to exist scenes prove added to the image that uses signs of reality to take those marks a new dimension not only across the image, but also the intervention of the narrator in the re-formation of this realism marks surrounding Palms perceived and visible and put markers regularly between what the narrative of privacy and image, fo
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were determine the problem of current research to answer the question on the consciousness of the Ministry of Agriculture to adopt Staffing strategy and identify the shortcomings as the independent variable, represented by the three dimensions (recruitment , selection, placement) and its impact on high performance, as dependent variable is described in four dimensions (leadership, strategy, structure and processes, culture), in this research were Used analytical descriptive style . This research aims to identify the correlation and impact of Staffing strategy at high-performance in Ministry of Agriculture , To clarify the relationship between
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