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.
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The subject of this research is an important topic, which is frequently repeated, and people need to know its wisdom, and has made it in front and the preface and three detectives, showed through discussion the meaning of the survey on the socks, its wisdom, its rules and conditions, and the duration of the survey on it, spoiled and reasoned and compared to the doctrinal doctrines, And the most correct statement of words I have concluded with a number of things, as follows:
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Time series analysis is the statistical approach used to analyze a series of data. Time series is the most popular statistical method for forecasting, which is widely used in several statistical and economic applications. The wavelet transform is a powerful mathematical technique that converts an analyzed signal into a time-frequency representation. The wavelet transform method provides signal information in both the time domain and frequency domain. The aims of this study are to propose a wavelet function by derivation of a quotient from two different Fibonacci coefficient polynomials, as well as a comparison between ARIMA and wavelet-ARIMA. The time series data for daily wind speed is used for this study. From the obtained results, the
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Background: Osteoid osteoma(OO) is a relatively common benign skeletal neoplasm of unknown etiology that is composed of osteoid and woven bone, usually seen in adolescent and young males Although, the clinical, radiological and scintigraphic features of OO have been well described, these features may be misleading or altered in the cases of lesser trochanter of the femur which is relatively uncommon location for OO with a few number of cases reported up to date. Case Presentation: We report a case of a 20-year-old man who presented with painful limpThe pain had begun six months earlier and was made worse by walking and by exercise., with normal initial X-rays .The diagnosis was made after six months when typical Computed tomography, magneti
... Show MoreObjectives: Obesity rates have increased globally with increase in the incidence of comorbidities especially type 2 diabetes mellitus. A cross-sectional study was conducted on healthy obese adults to estimate: (i) comparisons of anthropometric indicators, lipid profile, and glycemic profile in obese compared with non-obese, and (ii) the association of anthropometrics and lipid profile with glycemic profile in obese adults. Methods: The study includes 120 individual with aged ranged (25 – 55) years were enrolled in this study. They were divided into two groups: group one (G1) consist of 90 patients with a body mass index (BMI) of more than 25 kg/m2. Group two (G2) of 30 healthy adults as a co
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An excellent reputation earned by initiating and practicing sustainable business practices has additional benefits, of which are reducing environmental incidents and an improvement in operational efficiency as this has the potential to help firms improve on productivity and bring down operating costs. Taken further, with ever-increasing socially and environmentally-conscious investors and the public alike, this act of natural resources management could have a significant implication on market value and income of the practicing firms.
The above proposition has been supported by sustainable business practices literature that is continuously conversing and deliberating upon the impact of efficient resource d
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When industrial and constructional renaissance started in the world, the great interest was going on towards the equipment’s, which was the first mean for production. After industry was settled the interest was going on towards the men ship which manpower on which the production depends. It was approved that it represents the basic part in all of the processes and the protection of those individuals against dangers of these equipment’s, industry and its accidents was the basic things which was studied in many researches until it crystallized in general principles for all industries and other take care in each industry.
The professional safety is concerned as restrict which
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Morphological and phonological studies of fungal pathogen infecting alfalfa weevil Hypera postica (Gyllenhal) indicating that infection has been shown to develop along two distinct physiological lines, each culminating in the production of either conidial or resting spores, in host cadavers which are morphologically distinct. The percent of infection and epizootic development appeared to be dependent on host density. Farther evidence to entail proper correlation between conidia and resting spores suggest that these two forms of spores are stages in the development of one pathogen.
Neurolinguistics is a new science, which studies the close relationship between language and neuroscience, and this new interdisciplinary field confirms the functional integration between language and the nervous system, that is, the movement of linguistic information in the brain in receiving, acquiring and producing to achieve linguistic communication; Because language is in fact a mental process that takes place only through the nervous system, and this research shows the benefit of each of these two fields to the other, and this science includes important topics, including: language acquisition, the linguistic abilities of the two hemispheres of the brain, the linguistic responsibility of the brain centers, and the time limit for langua
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