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 surgery Keywords: Non-surgical treatment of anal fissure, fissure in ano, sphicterotomy,botulinum toxin in anal fissures, glyceryl trinitrate. Chemical sphincteratomy, pharmacological sphincteratomy.
The term "semantic exchange" was popularized in Arabic, especially in derivatives, grammatical structures, etc., but it came under different names or terms, including deviation, deviation, transition, displacement, tooth breach, replacement, attention, etc. In the rooting of this term through its study in language and terminology, and among linguists, grammar and others, we have reached a number of results, including The existence of a harmonization between the lexical and idiomatic meaning of the term exchange, and the phenomenon of semantic exchange is a form of expansion in language, and that the first language scientists They had turned to this And studied under Cairo for different names, as noted above.
Background: Lung cancer is responsible for the most
cancer deaths in both men and women throughout the
world. Deaths from lung cancer (160,440 in 2004,
according to the National Cancer Institute) exceed the
number of deaths from four other major cancers combined
(breast, colon, pancreatic and prostate).
Objective: To assess the behavior and the approaches of
lung cancer in a sample of Iraqi patients.
Methods: This descriptive retrospective study was
performed using the records of 390 patients proved to have
lung cancer that had attending the Thoracic Surgery
Department of Surgical Specialties Hospital-Medical City
\Baghdad for the period from January, 1st
, 2001 to
December, 31st
,2002.
Res
This work aims to analyze a three-dimensional discrete-time biological system, a prey-predator model with a constant harvesting amount. The stage structure lies in the predator species. This analysis is done by finding all possible equilibria and investigating their stability. In order to get an optimal harvesting strategy, we suppose that harvesting is to be a non-constant rate. Finally, numerical simulations are given to confirm the outcome of mathematical analysis.
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DBN Rashid, Rimak International Journal of Humanities and Social Sciences, 2020
There are many ways to communicate a story, one can tell it, sing it, act it, write it, film it and can draw it. Each form of storytelling has its unique characteristics that separate it from the other forms. These distinguishing characteristics of each form does not indicate the superiority of one form over the other, on the contrary, it indicates the human ability to be creative on many levels. As students of literature, only the written form of a story is taken into account. One reason for the negligence of other forms of storytelling might be that singing and filming a story is not related to literature. But there has been a form of storytelling that uses words along with pictures which eventually became a genre of novels called grap
... Show MoreA prepared PMMA/Anthracene film of thickness 70μm was irradiated under reduced pressure ~10-3 to 60Coγ-ray dose of (0.1mrad-10krad) range. The optical properties of the irradiated films were evaluated spectrophotometrically. The absorption spectrum showed induced absorption changes in the 200-400nm range. At 359nm, where there is a decrease in radiation-induced absorption, the optical density as a function of absorbed dose is linear from 10mrad-10Krad.It can therefore, be used as radiation dosimeter for gamma ray in the range 10mrd-10krad
The samples were collected monthly crustaceans Mjmafah foot of two stations in tributary Zab down and two others in the Tigris River for one year with effect from November 2001 until October 2002 recorded during the study period the current 41 units taxonomic and were higher density of Mjmafah foot Guy Tigris River before the mouth of the tributary
The study aims to identify the colleges women in the USA where he was browsing the Internet for five universities and sixty-two women's college located these colleges in 25 states only three general and other civil 51% supported by the churches and religious associations of various began its founding in Alqrnn eighteenth and continued in the nineteenth and twentieth and to provide an opportunity for women to complete higher education, while most men's colleges opened their doors to the admission of women and turned it on coeducation
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