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 calculation. of the nuclear. charge. density. distributions. ρ(r) and root. mean. square. radius.( RMS ) by elastic. electron. scattering. of medium. mass. nuclei. such. as (90Zr, 92Mo) based. on the model. of the modified. shell. and the use of the probability. of occupation. on the surface. orbits. of level 2p, 2s eroding. shells. and 1g gaining. shells. The occupation probabilities of these states differ noticeably from the predictions of the SSM. We have found. an improvement. in the determination. of ground. charge. density. and this improvement. allow. more precise. identification. of (CDD) between. (92Mo- 90Zr) to illustrate the influence of the extra
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the researchers Sought to determine the impact of the customer contact (Within a client contact there are two times, first is the total time required to create a service and within it there is contact time while the second time is the time of client contact ؛ where means a time that records the physical presence of the customer during the process of service) on operations performance by concentrate attention on the cost (labor productivity) and quality (patient ratio to the doctor) and speed (cycle time) and flexibility (the flexibility range) , as well as ruling out variable of innovation because of impossibility to measure this variable in the Specialty Center for Dental in al-alwia due to the center is lacking of mechanisms t
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(3)
(2)
الملخص ان حق الملكية هو الحق الاوسع نطاقا يمنح صاحبه صلاحية ممارسة السلطات كافة ويكون محل هذه السلطات كل ما يملك الشخص سواء كان شقه او طبقة اسوة بالعقارات الاخرى كدار للسكن او ارض ، ومن اهم هذه السلطات واوسعها نطاقا ( هو سلطة التصرف ). تعد هذه السلطة جوهر حق الملكية وأخطر السلطات الممنوحة للمالك كونه بواسطتها يمكنه الاستغناء عن ملكه بأي تصرف ناقل له كالبيع أو الهبة او الوصية مثلا ، ولأهمية هذه السلط
... Show MoreBackground: Schneiderian first rank symptoms are
considered highly valuable in the diagnosis of
schneideria.
They are more evident in the acute phase of the
disorder and fading gradually with time. Many studies
have shown that the rate of these symptoms are
variable in different countries and are colored by
cultural beliefs and values.
Objectives: To find out the rate of Schneiderian first
rank symptoms among newly diagnosed schizophrenic
patients, to assess which symptom(s) might
predominate in those patients, and to find out if there
is/are any correlation(s) between the occurrence of
these symptoms and the sex of the patients.
Methods: Out of twenty-four patients with no past
psychiatric hi
This paper adapted the neural network for the estimating of the direction of arrival (DOA). It uses an unsupervised adaptive neural network with GHA algorithm to extract the principal components that in turn, are used by Capon method to estimate the DOA, where by the PCA neural network we take signal subspace only and use it in Capon (i.e. we will ignore the noise subspace, and take the signal subspace only).
The m-consecutive-k-out-of-n: F linear and circular system consists of n sequentially connected components; the components are ordered on a line or a circle; it fails if there are at least m non-overlapping runs of consecutive-k failed components. This paper proposes the reliability and failure probability functions for both linearly and circularly m-consecutive-k-out-of-n: F systems. More precisely, the failure states of the system components are separated into two collections (the working and the failure collections); where each one is defined as a collection of finite mutual disjoint classes of the system states. Illustrative example is provided.
The analysis of survival and reliability considered of topics and methods of vital statistics at the present time because of their importance in the various demographical, medical, industrial and engineering fields. This research focused generate random data for samples from the probability distribution Generalized Gamma: GG, known as: "Inverse Transformation" Method: ITM, which includes the distribution cycle integration function incomplete Gamma integration making it more difficult classical estimation so will be the need to illustration to the method of numerical approximation and then appreciation of the function of survival function. It was estimated survival function by simulation the way "Monte Carlo". The Entropy method used for the
... Show MoreThe current research deals with short term forecasting of demand on Blood material, and its' problem represented by increasing of forecast' errors in The National Center for Blood Transfusion because using inappropriate method of forecasting by Centers' management, represented with Naive Model. The importance of research represented by the great affect for forecasts accuracy on operational performance for health care organizations, and necessity of providing blood material with desired quantity and in suitable time. The literatures deal with subject of short term forecasting of demand with using the time series models in order to getting of accuracy results, because depending these models on data of last demand, that is being sta
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