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 surgery Keywords: Non-surgical treatment of anal fissure, fissure in ano, sphicterotomy,botulinum toxin in anal fissures, glyceryl trinitrate. Chemical sphincteratomy, pharmacological sphincteratomy.
In this paper, we will focus to one of the recent applications of PU-algebras in the coding theory, namely the construction of codes by soft sets PU-valued functions. First, we shall introduce the notion of soft sets PU-valued functions on PU-algebra and investigate some of its related properties.Moreover, the codes generated by a soft sets PU-valued function are constructed and several examples are given. Furthermore, example with graphs of binary block code constructed from a soft sets PU-valued function is constructed.
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The Turks used the Ottoman Turkish language from the thirteenth century to the twentieth century. During this period and under the influence of Islamic civilization, a large number of words and structures were used from the Arabic and Persian languages, Therefore, many Arabic grammatical structures were used in the Ottoman Turkish language, such as the definite article simply because it was widely used.
The paper is concerned with the use of the Arabic definite article in the Ottoman Turkish language, and the aim of this contrastive study is to find out the similarities and differences between the two languages in terms of meaning and structure. Since linguistic studies depend on the practical side or applied approach, two
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The research aim to the usage educational method for jump shooting and it effect on speed strength in basketball for the specialist students in College Sport of Dayla University, which used the following statistic treatment (The T.test for compatible specimens), so after statistic treatment which appears theres a tow moral differences in speed strength and jump shooting tests results to (legs & arms) for the before and after tests, and after that the conclusions we positive and the second the special drills effect immaterial speed strength to legs and arms, so the tow researches recommended to looking after the best for educational methods that used in our sport colleges in Iraq.
Acromegaly is ametabolic disorder characterized by an acquired progressive somatic disfigurement, mainly involving the face, extremities and many other organs, that are associated with systemic manifestations, caused by excessive secretion of growth hormone and a resultant persistent elevation of insulin-like growth factor-I concentrations. In more than 90% of cases originates from a monoclonal benign pituitary adenoma. Aim of this study to assess the level of insulin-like growth factor-I (IGF-I) in saliva of acromegalic patients, and to compare it with the basal levels of serum IGF-I. Sixty specimens of serum and saliva collected from two groups of subjects (forty acromegalic patients and twenty healthy persons). The specimens were
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Abstract
The goal of current research to describe and diagnose the level of attention of doctors to design and regulatory dimensions, (strategic vision, organizational structure, organizational processes, business systems, personnel), and the performance of hospitals and dimensions, in six hospitals in medicine and selected a sample for research, as well as identify organizational design effect in the performance of hospitals and dimensions (efficiency, the development of human resources, patient satisfaction, achieve financial results, quality of health care).
Research has focused in part theoretical on key variables to look organizational des
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