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.
We present the notion of bipolar fuzzy k-ideals with thresholds (
Background: The highest concentrations of
blood glucose during the day are usually found
postprandialy. Postprandial hyperglycemia (PPH)
is likely to promote or aggravate fasting
hyperglycemia. Evidence in recent years suggests
that PPH may play an important role in functional
& structural disturbances in different body organs
particularly the cardiovascular system.
Objective: To evaluate the effect of (PPH) as a
risk factor for coronary Heart disease in Type 2
diabetic patients.
Methods: Sixty-three type2 diabetic patients
were included in this study. All have controlled
fasting blood glucose, with HbA1c correlation.
They were all followed for five months period
(from May to October 2008)
Solar activity monitoring is important in our life because of its direct or indirect influence on our life, not only on ionospheric communications. To study solar activity, researchers need measuring and monitoring instruments, these instruments are mostly expensive and are not available in all universities. In this paper, a very low frequency radio receiver had been designed and implemented with components available in most markets to support the researchers, college students, and radio astronomy amateurs with a minimum input voltage less than 100µV, an output voltage less than 135 m V with no distortion and an overall gain of 34dB. A comparison had been done between two circuit structures using a workbench software program and experim
... Show MoreSJ Mohammed, AA Noaimi, KE Sharquie, JM Karhoot, MS Jebur, JR Abood, A Al-Hamadani, Al-Qadisiyah Medical Journal, 2015 - Cited by 20
There is no adopt in the importance of the optical communications in scientific civil and military applications because of it’s simplicity in manufacturing and it's low cost. The method of optical communication depends upon bearing the light beam the translated informations by a method called the light modulation. This method depends upon changing some light properties as frequency, amplitude and pulse duration according to the translating informations. The changes in the first two properties are concerned optically with the analog modulation while the third one concern at most with digital modulation. All past methods are expensive with low efficiency and needs electrical or magnetic fields. In this technique the source of voice used
... Show MoreThe experiment was aimed to evaluate a locally manufactured a dual-action device used for measuring feed pellets durability. The device performs dropping process in conventional devices, then sifting process to separate the pellets from the crumbles simultaneously, with a control the motor speed by using the pulse width modulation (PWM) Technique. The device performance was compared with the durability measuring device of a moving drop box. Rotational speed, diameter of the die holes of the machine was used in this study. The results showed that increasing the rotational speed of the die from 280 to 300 and to 320 rpm, increasing the die holes diameter from 3 to 4 and to 5 mm, led to