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 main objective of resources management is to supply and support the site operation with necessary resources in a way to achieve the required timing in handing over the work as well as to achieve the cost-realism within the budget estimated. The research aims to know the advantage of using GIS in management of resources as one of the new tools that keep pace with the evolution in various countries around the world also collect the vast amount of spatial data resources in one environment easily to handled and accessed quickly and this help to make the right decision regarding management of resources in various construction projects. The process of using GIS in the management and identification of resources is of extreme importance in t
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The research in the linguistic structures of the historians Al-Yaqoubi is considered a model of the important topics in historical studies in general, given its importance in the lives of peoples due to its connotations and meanings that summarize interpretation, clarification, and prolonged speech, as it includes life meanings with many dimensions, these structures have been used in historical incidents Important, and throughout the different ages, as it can be used to support an opinion, solve problems, prove evidence, increase wisdom, and it needs rich life experiences, and a sound language, to use it, and needs a wide absorptive capacity for the recipient, the research included linguistic structures in the achievement of science , Lingu
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Background: The objective of this study was to investigate the possibility of standardizing the Bolton ratio analysis as a diagnostic measure for both Iraqi and Egyptian orthodontic populations within three Angle' classification groups. Materials and methods: Two hundred forty pretreatment study casts (one hundred twenty of each population) were included in this study and divided into three Angle' classification groups. The mesiodistal crown diameters of all teeth were measured for computing the anterior and total Bolton ratios. Analysis of variance was performed to compare the mean ratios of Bolton analysis as a function of the Angle classification.HSD test was used to specify the classes of malocclusion that have significant differences.
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Background: This study aimed to determine the cephalometric values of tetragon analysis on a sample of Iraqi adults with normal occlusion. Material and methods: Forty digital true lateral cephalometric radiographs belong to 20 males and 20 females having normal dental relation were analyzed using AutoCAD program 2009. Descriptive statistics and sample comparison with Fastlicht norms were obtained. Results: The results showed that maxillary and mandibular incisors were more proclined and the maxillary/mandibular planes angle was lower in Iraqi sample than Caucasian sample. Conclusion: It's recommended to use result from this study when using tetragon analysis for Iraqis to get more accurate result.
A new efficient Two Derivative Runge-Kutta method (TDRK) of order five is developed for the numerical solution of the special first order ordinary differential equations (ODEs). The new method is derived using the property of First Same As Last (FSAL). We analyzed the stability of our method. The numerical results are presented to illustrate the efficiency of the new method in comparison with some well-known RK methods.
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