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.
The article reflects the results of the analysis of the use of metaphors as one of the main means used by Lyudmila Ulitskaya when writing the novel “Sincerely Yours Shurik” to form the image of the main hero in the novel. The main purpose of the article is to consider metaphors, which helped the author to form the image of the main character Shurik in the text space through the stages of his life path, closely related to the people around him, who is always happy to be useful (hence the title "Sincerely Yours"), among which the female images of his relatives, girlfriends and others stand out as a special layer in the narrative. And in the course of the study, the following tasks were solved: the metaphors that make up the image of the
... Show Moren this research, some thermophysical properties of ethylene glycol with water (H2O) and two solvent mixtures dimethylformamide/ water (DMF + H2O) were studied. The densities (ρ) and viscosities (η) of ethylene glycol in water and a mixed solvent dimethylformamide (DMF + H2O) were determined at 298.15 K, t and a range of concentrations from 0.1 to1.0 molar. The ρ and η values were subsequently used to calculate the thermodynamics of mixing including the apparent molar volume (ϕv), partial molar volume (ϕvo) at infinite dilution. The solute-solute interaction is presented by Sv results from the equation ∅_v=ϕ_v^o+S_v √m. The values of viscosity (B) coefficients and Falkenhagen coefficient(A) of the Jone-Dole equation and Gibbs free
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In this work, we introduced the Jacobson radical (shortly Rad (Ș)) of the endomorphism semiring Ș = ( ), provided that is principal P.Q.- injective semimodule and some related concepts, we studied some properties and added conditions that we needed. The most prominent result is obtained in section three
-If is a principal self-generator semimodule, then (ȘȘ) = W(Ș).
Subject Classification: 16y60
Abstract
Theoretical and experimental methodologies were assessed to test curved beam made of layered composite material. The maximum stress and maximum deflection were computed for each layer and the effect of radius of curvature and curve shape on them. Because of the increase of the use of composite materials in aircraft structures and the renewed interest in these types of problems, the presented theoretical assessment was made using three different approaches: curved beam theory and an approximate 2D strength of material equations and finite element method (FEM) analysis by ANSYS 14.5 program for twelve cases of multi-layered cylindrical shell panel differs in fibe
... Show MoreCollapse of the vapor bubble condensing in an immiscible is investigated for n-pentane and n-hexane vapors condensing in cold water and n-pentane in two different compositions of glycerin- water mixture. The rise velocity and the drag coefficient of the two-phase bubble are measured.
Many of the signs that the global energy system indicate the start of a period of transition from total dependence on fossil energy sources, especially oil, into a new era in which alternative energy sources play an important role in meeting the growing needs of energy demand, so sought many of the developed countries through research the studies carried out to try to bring renewable energy sources and non-renewable (shale oil, oil sands, solar energy, wind energy .... etc) replace traditional fossil energy sources (oil, gas, coal) and despite the recent availability dramatically and spread throughout the the world, but they are going to dry up in the foreseeable future. So many countries, especially the developed sought to find
... Show MoreAnastatica hierochuntica is believed to be very useful in Arab countries for treating various health disorders. The aqueous extract of Anastatica hierochuntica was investigated for its effects on hormones in mice females. the aqueous extract of plant at a dose level of 100mg/1mL showed significant increase (p<0.05) on levels of hormones LH, FSH, PRL level and PRO level. Clomid treated group showd significant increase in LH, FSH, and PRL while there was non-significant increase in PRO. From the above results, it is concluded for the first time that aqueous Anastatica hierchuntica extract offers significant effect of LH, FSH, PRL, and PRO in this mice females scompared with control.
Low bearing capacity of weak soil under shallow footings represents one of construction problems.
Kaolin with water content converges to liquid limit used to represent the weak soil under shallow
footing prototype. On the other hand, fly ash, which can be defined as undesirable industrial waste
material, was used to improve the bearing capacity of the soft soil considered in this research. The soft
soil was prepared in steel box (36×36×25) cm and shallow square footing prototype (6×6) cm were
used .Group of physical and chemical tests were conducted on kaolin and fly ash. The soft soil was
improved by a bed of compacted fly ash placed under the footing with dimensions equal to that of
footing but with different de
This aims tackles the importance of the organizational energy of the hotel organizations that search the success in the business field to penetrate in the whole tourist markets, and to draw the policies and firm rules which must be framed with the administrative strategies that contributed in creativity and achievement the targets besides provide a future vision due to its position among the competitive henceforth achieving the activity. This is what the chapters tackle in the theoretical side. Also many general questions have been arisen to determinate the importance of the research and many other special questions that express the problem of the study. To limit the levels of study alter
... Show MoreUrban wetlands are one of the complex systems that provide many economic, social and environmental services to the city. In this research, the most important services provided by urban wetlands from the point of view of the urban planner were reviewed, and the types of these lands and their divisions according to the type of services provided by each type were presented. Environmental is represented in its ability to reduce the dangers of floods, mitigate the climate and reduce its negative impacts, purify water and deplete a lot of suspended impurities and pollutants, and social services such as recreational areas and beautiful landscapes that inspire joy and reassurance in the soul, as well as cultural areas and sports activities for m
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