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 the current paradigms of information technology, cloud computing is the most essential kind of computer service. It satisfies the need for high-volume customers, flexible computing capabilities for a range of applications like as database archiving and business analytics, and the requirement for extra computer resources to provide a financial value for cloud providers. The purpose of this investigation is to assess the viability of doing data audits remotely inside a cloud computing setting. There includes discussion of the theory behind cloud computing and distributed storage systems, as well as the method of remote data auditing. In this research, it is mentioned to safeguard the data that is outsourced and stored in cloud serv
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Objective: Geographic differences in clinical and pathological aspects of ameloblastoma have been suggested, therefore the purpose of this study was to analyze cases of ameloblastoma in terms of clinical and radiographic manifestations, histopathological types, treatment modalities and recurrence rate and compare them with reports from other parts of the world. Methods: The medical reports of patients diagnosed with ameloblastoma were reviewed and the data concerning the age, gender, chief complaint, the anatomical site of the lesion, radiographic appearance, histopathological diagnosis, treatment approach and recurrence were retrieved. Surgical treatment consisted of either enucleation with curettage and peripheral ostectomy or resection;
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Lifestyle Medicine is the application of evidence-based lifestyle approaches for the prevention, treatment, and even the reversal of lifestyle-related chronic diseases such as diabetes, hypertension, heart disease, obesity, polycystic ovarian diseases, dementia, arthritis, and cancers
In this study, the dynamic modeling and step input tracking control of single flexible link is studied. The Lagrange-assumed modes approach is applied to get the dynamic model of a planner single link manipulator. A Step input tracking controller is suggested by utilizing the hybrid controller approach to overcome the problem of vibration of tip position through motion which is a characteristic of the flexible link system. The first controller is a modified version of the proportional-derivative (PD) rigid controller to track the hub position while sliding mode (SM) control is used for vibration damping. Also, a second controller (a fuzzy logic based proportional-integral plus derivative (PI+D) control scheme) is developed for both vibra
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Abstract: In this research, nanofibers have been prepared by using an electrospinning method. Three types of polymer (PVA, VC, PMMA) have been used with different concentration. The applied voltage and the gap length were changed. It was observed that VC is the best polymer than the other types of polymers.
Purpose/objective:
1 - To explain the financial impact of the activities and areas of human resources management and the adoption of the methodology for estimating costs on the basis of conduct and statement of how to assess costs and benefits of human resource activities.
2 - Measuring human capital, and its impact on the financial statements.
Design/methodology/approach:
Concentrated dimensions of the research paper's lack of financial statements prepared by the organizations for information mandated human resource its components of the three (attraction - development
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In this research, nanofibers have been prepared by using an electrospinning method. Three types of polymer (PVA, VC, PMMA) have been used with different concentration. The applied voltage and the gap length were changed. It was observed that VC is the best polymer than the other types of polymers.
This paper studies the demonstratives as deictic expressions in Standard Arabic and English by outlining their phonological, syntactic and semantic properties in the two languages. On the basis of the outcome of this outline, a contrastive study of the linguistic properties of this group of deictic expressions in the two languages is conducted next. The aim is to find out what generalizations could be made from the results of this contrastive study.
A study of the hadiths of supplication orchestration