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.
A theoretical model is developed to determine time evolution of temperature at the surface of an opaque target placed in air for cases characterized by the formation of laser supported absorption waves (LSAW) plasmas. The model takes into account the power temporal variation throughout an incident laser pulse, (i.e. pulse shape, or simply: pulse profile).
Three proposed profiles are employed and results are compared with the square pulse approximation of a constant power.
ان السبب الرئيسي لاختيار الموضوع كونه من الاساليب الادارية الحديثة التي تهدف الى انجاح المنظمة او الشركة المبحوثة, اذ تمثلت مشكلة البحث في ما دور الادارة بالرؤية المشتركة في تعزيز التسويق الابداعي بالشركة المبحوثة, يهدف البحث الى تسليط الضوء على مفهوم الادارة بالرؤية المشتركة وانعكاساتها على التسويق الابداعي للمنظمة ، باعتبارها منهج اداري حديث يسهم في تغيير وتجديد وتطوير واقع المنظمة المبحوثة( الشرك
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The research deals with the principle of the prohibition of international waterway diversion in the law of international watercourses. The research reviews individual and collective doctrinal efforts that have touched upon the principle as an internationally wrongful act because of its serious damage and consequences for downstream States. The research addresses the nature of the principle of the prohibition of diversion of international watercourses; its various effects; principles of international law establishing the principle of prohibition of diversion; and its application in State practice and international justice. This principle has been enshrined in most international treaties and judicial decisions. The principle of prohibition
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Aspect categorisation and its utmost importance in the eld of Aspectbased Sentiment Analysis (ABSA) has encouraged researchers to improve topic model performance for modelling the aspects into categories. In general, a majority of its current methods implement parametric models requiring a pre-determined number of topics beforehand. However, this is not e ciently undertaken with unannotated text data as they lack any class label. Therefore, the current work presented a novel non-parametric model drawing a number of topics based on the semantic association present between opinion-targets (i.e., aspects) and their respective expressed sentiments. The model incorporated the Semantic Association Rules (SAR) into the Hierarchical Dirichlet Proce
... Show MoreThe theoretical analysis depends on the Classical Laminated Plate Theory (CLPT) that is based on the Von-K ráman Theory and Kirchhov Hypothesis in the deflection analysis during elastic limit as well as the Hooke's laws of calculation the stresses. New function for boundary condition is used to solve the forth degree of differential equations which depends on variety sources of advanced engineering mathematics. The behavior of composite laminated plates, symmetric and anti-symmetric of cross-ply angle, under out-of-plane loads (uniform distributed loads) with two different boundary conditions are investigated to obtain the central deflection for mid-plane by using the Ritz method. The computer programs is built using Ma
... Show MoreLow grade crude palm oil (LGCPO) presents as an attractive option as feedstock for biodiesel production due to its low cost and non-competition with food resources. Typically, LGCPO contains high contents of free fatty acids (FFA), rendering it impossible in direct trans-esterification processes due to the saponification reaction. Esterification is the typical pre-treatment process to reduce the FFA content and to produce fatty acid methyl ester (FAME). The pre-treatment of LGCPO using two different acid catalysts, such as titanium oxysulphate sulphuric acid complex hydrate (TiOSH) and 5-sulfosalicylic acid dihydrate (5-SOCAH) was investigated for the first time in this study. The optimum conditions for the homogenous catalyst (5-SOCAH) wer
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This study aims to evaluate the performance of the sewage treatment plant in Al-Diwaniya, one of cities in the southern part in Iraq. This evaluation could be used to facilitate effluent quality assessment or optimal process control of the plant. The influent reaching the plant is considered a medium to strong in strength with BOD5/COD ratio in the range 0.23 and 0.69 which can be considered an easily degradable sewage by the biological processes performed by the activated sludge unit. The quality of the effluent was found to be higher than the Iraqi standards for disposal to water bodies. The BOD5/COD ratios of the treated sewage varied over a wide range as low of 0.13 to 1.48 indicating operational problems in the plant. Regression ana
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This study aims to evaluate the performance of the sewage treatment plant in Al- Diwaniya, one of cities in the southern part in Iraq. This evaluation could be used to facilitate effluent quality assessment or optimal process control of the plant. The influent reaching the plant is considered a medium to strong in strength with BOD5/COD ratio in the range 0.23 and 0.69 which can be considered an easily degradable sewage by the biological processes performed by the activated sludge unit. The quality of the effluent was found to be higher than the Iraqi standards for disposal to water bodies. The BOD5/COD ratios of the treated sewage varied over a wide range as low of 0.13 to 1.48 indicating operational problems in the plant. Regressio
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