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.
Roller Compacted Concrete is a type of concrete that is environmentally friendly and more economical than traditional concrete. Roller Compacted Concrete is typically used for heavy-duty and specialist constructions, such as hydraulic structures and pavements, because of its coarse surface. The main difference between RCC and conventional concrete mixtures is that RCC has a more significant proportion of fine aggregates that allow compaction and tight packing. In recent years, it has been estimated that several million tons of waste demolished material (WDM) produced each year are directed to landfills worldwide without being recycled for disposal. This review aimed to study the literature about creating a Roller-Comp
... Show MoreFiber Bragg Grating has many advantages where it can be used as a temperature sensor, pressure sensor or even as a refractive index sensor. Designing each of this fiber Bragg grating sensors should include some requirements. Fiber Bragg grating refractive index sensor is a very important application. In order to increase the sensing ability of fiber Bragg gratings, many methods were followed. In our proposed work, the fiber Bragg grating was written in a D-shaped optical fiber by using a phase mask method with KrFexcimer. The resultant fiber Bragg grating has a high reflectivity 99.99% with a Bragg wavelength of 1551.2 nm as a best result obtained from a phase mask with a grating period of 1057 nm. In this work it was found that the rota
... Show MoreThe objective of this research paper is two-fold. The first is a precise reading of the theoretical underpinnings of each of the strategic approaches: "Market approach" for (M. Porter), and the alternative resource-based approach (R B V), advocates for the idea that the two approaches are complementary. Secondly, we will discuss the possibility of combining the two competitive strategies: cost leadership and differentiation. Finally, we propose a consensual approach that we call "dual domination".
Modeling forward kinematics with neural networks allows for efficient handling of nonlinear relationships and realistic error correction in time-critical applications by relying on accurate training data. This paper presents a Multi-Layer Feed-Forward Neural Network (MLFFNN) to solve the forward kinematics of a 3-DOF robot. The proposed MLFFNN consists of 50 hidden neurons and was trained using 628319 samples to find only the position (x, y, z) of the end-effector. Data were generated by MATLAB, assuming an incremental motion of joints. The joint variables ( , , and ) are the inputs of the NN, which outputs the positions of the end effector (x, y, z) calculated using the Denavit-Hartenberg (DH) method. The results demonstrate that t
... Show MoreModern statistical techniques offer a range of methodologies for modelling time series data, with conditional and unconditional approaches providing complementary insights that enhance overall model accuracy. This article introduced a modified ARIMA model employing conditional and unconditional parameter estimates. The methodology for the new model based on novel methods is provided. The prediction process, one and two steps ahead, is covered in detail, and a novel algorithm is presented. The best model is picked based on various measurement criteria, such as coefficient of determination (R2), root mean squared error (RMSE), and mean absolute scaled error (MASE). The suggested model is applied to a monthly petrol sales dataset (Jan
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Abstract
This research aims to identify the relationship and the impact of the behavior of organizational citizenship in the performance of employees, as practiced behaviors organizational citizenship substantial role in achieving the objectives of both the organization and its staff at the same time, so it affects a large extent on the characteristics and performance of individuals employees and thus influence the success of the organization as a whole, problem of the research has indicated that there is a clear failure in the study of the impact of the behavior of organizational citizenship in the performance of employees, was chosen
This research aims at identifying the communicative habits and content reflections on the communication process, especially the young audience which is one of the main group for whom the announcements are made. Because young people face life with passion and aspiration making them respond to each effect used by the media in the design of the advertising using all the effective techniques, attractive methods for young children like depending on drama, technical tricks, music and logos easily to be remembered and responded to the desires of the young in their entertainment. This research also aims at identifying the impact of the internet as a channel of commercial advertising on the purchasing behavior of young people at the universities
... Show MoreWireless sensor applications are susceptible to energy constraints. Most of the energy is consumed in communication between wireless nodes. Clustering and data aggregation are the two widely used strategies for reducing energy usage and increasing the lifetime of wireless sensor networks. In target tracking applications, large amount of redundant data is produced regularly. Hence, deployment of effective data aggregation schemes is vital to eliminate data redundancy. This work aims to conduct a comparative study of various research approaches that employ clustering techniques for efficiently aggregating data in target tracking applications as selection of an appropriate clustering algorithm may reflect positive results in the data aggregati
... Show MoreReading is one of the essential components of the English language. Countries that use English as a second language (ESL) sometimes have difficulties in reading and comprehension. According to many researches, mother tongue has proved some interferences with learning a second language. This study investigated the results of reading difficulties of young second language learners in terms of accuracy, comprehension, and rate using the Neale Analysis of Reading Ability test. The study was carried out in one of the High Schools for Boys in Hyderabad, India and included Grade five, aged 10-12 years. In order to understand the reading difficulties of English as a second language, a qualitative approach was employed. Interview, reading tes
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