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.
This study investigated the cubic intuitionistic fuzzy set of TM-algebra as a generalization of the cubic set. First, a cubic intuitionistic ideal and a cubic intuitionistic T-ideal are defined, followed by a discussion of their properties. Furthermore, the level set of a cubic intuitionistic TM-algebra is defined, and the relationship between a cubic intuitionistic level set and the cubic intuitionistic T-ideal is established. A novel definition of a cubic intuitionistic set under homomorphism is proposed, and several significant results are demonstrated.
Over the past few years, ear biometrics has attracted a lot of attention. It is a trusted biometric for the identification and recognition of humans due to its consistent shape and rich texture variation. The ear presents an attractive solution since it is visible, ear images are easily captured, and the ear structure remains relatively stable over time. In this paper, a comprehensive review of prior research was conducted to establish the efficacy of utilizing ear features for individual identification through the employment of both manually-crafted features and deep-learning approaches. The objective of this model is to present the accuracy rate of person identification systems based on either manually-crafted features such as D
... Show MoreAmeloblastic carcinoma is a rare malignant odontogenic tumor that is further classified into being primary or secondary arising from a preexisting benign ameloblastoma. It affects the mandible in two thirds of the patients. there is no standard treatment protocol for this lesion but radical surgical excision with or without radiotherapy is reported in the majority of cases. In this paper we present a case of a 60 year old female diagnosed with ameloblastic carcinoma of the mandible that was treated by radical resection of the mandible with selective neck dissection and postoperative radiotherapy.
The right to property is one of the most prominent and most important of the fundamental rights that the individual enjoys, whether national or foreign, both of them have their own private property that may not be affected except for the requirements of the country's economic development or what is known as the public benefit, and the Iraqi legislator did not specify what is meant by the removal of foreign investment. Of the bilateral international agreements (BITS), as it determined its terms and methods, the properties of foreign investors may be expropriated in a direct and indirect way.
The current research is concerned with studying the decisive answers which are considered quick and conclusive. These answers can effectively interrupt the opponent's argument and close the dialogue.This research is concentrated on deliberative methodology focusing on the decisive answer's activity and ending them through several completing and argument sides. This research consists of an introduction and three parts, the current introduction is focused the light on the concept of decisive answers and its uses in literature and the scarce of speech, and how to consider it with one dialogue description,that dialogue constitute by ? The first part is concerned with those answers through the deliberative methodology and classifying decisive
... Show MoreIn this paper a nonlinear adaptive control method is presented for a pH process, which is difficult to control due to the nonlinear and uncertainties. A theoretical and experimental investigation was conducted of the dynamic behavior of neutralization process in a continuous stirred tank reactor (CSTR). The process control was implemented using different control strategies, velocity form of PI control and nonlinear adaptive control. Through simulation studies it has been shown that the estimated parameters are in good agreement with the actual values and that the proposed adaptive controller has excellent tracking and regulation performance.