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 objective of this review was to describe the COVID-19 complications after recovery.
The researchers systematically reviewed studies that reported post-COVID-19 complications from three databases: PubMed, Google Scholar and the World Health Organization (WHO) COVID-19 database. The search was conducted between 21 November 2020 and 14 January 2021. Inclusion criteria were articles written in English, with primary data, reporting complications of COVID-19 after full
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The discourse surrounding lingual sovereignty within the African postcolonial context is profoundly intertwined with the fabric of cultural identity and self-determination. Language serves not merely as a conduit for communication but as a repository for a people's collective consciousness, encapsulating their traditions, thoughts, and perspectives. In the realm of postcolonial literature, this dialogue often grapples with the paradox of expressing indigenous narratives through the linguistic tools of former colonizers. Chinua Achebe's seminal work, "Things Fall Apart," exemplifies this conundrum, artfully weaving the orature and culture of Umuofia within the English language. Achebe's choice to write in English—a language imposed upon hi
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Trialeurodes irakensis sp. n. is describe and illustrated from Iraq. T.vaporariorurn (westwood)
is reported and for the first time for the Iraqi fauna. A ke to species of Trialeurodes found in
Iraq is presented.
This paper proposes a self organizing fuzzy controller as an enhancement level of the fuzzy controller. The adjustment mechanism provides explicit adaptation to tune and update the position of the output membership functions of the fuzzy controller. Simulation results show that this controller is capable of controlling a non-linear time varying system so that the performance of the system improves so as to reach the desired state in a less number of samples.
The atomic properties have been studied for He-like ions (He atom, Li+, Be2+ and B3+ions). These properties included, the atomic form factor f(S), electron density at the nucleus , nuclear magnetic shielding constant and diamagnetic susceptibility ,which are very important in the study of physical properties of the atoms and ions. For these purpose two types of the wave functions applied are used, the Hartree-Fock (HF) waves function (uncorrelated) and the Configuration interaction (CI) wave function (correlated). All the results and the behaviors obtained in this work have been discussed, interpreted and compared with those previously obtained.
In this article, we aim to define a universal set consisting of the subscripts of the fuzzy differential equation (5) except the two elements and , subsets of that universal set are defined according to certain conditions. Then, we use the constructed universal set with its subsets for suggesting an analytical method which facilitates solving fuzzy initial value problems of any order by using the strongly generalized H-differentiability. Also, valid sets with graphs for solutions of fuzzy initial value problems of higher orders are found.
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Objective: An efficient solution for stabilization is the mobilization of the joints for the arthrokinematics affected by the positional defect of the CAI (i.e. chronic ankle instability). This study put to comparison the impacts of ankle dorsi flexion range of motion (DFROM) as well as dynamic balance ability (DBA) in the patients who have CAI using PJM (i.e. passive joint mobilization), a technique typically been used in previous works, and active joint mobilization (AJM), a technique which could have a greater impact on cortical excitability with the spontaneous movement. Design: rehabilitation program to treat recurrent ankle. Methods: A total of 10 players from the Iraqi clubs Muay Thai team were registered, 5 from each of
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