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.
This research study examines the impact of information technology on firm profitability and stock returns. Using a comprehensive dataset of firms across various industries, this research employs rigorous statistical analysis techniques to investigate the relationship between IT investments, firm profitability metrics, and stock returns. The study focuses at how IT investments affect financial performance measures including return on assets (ROA) and return on equity (ROE), with P-values of 0.34 and 0.12, respectively. Furthermore, the study investigates the influence of IT on stock returns, taking into account market capitalization, industry trends, and macroeconomic variables. This study's conclusions center on the beneficial assoc
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This study explores the theory of Ecofeminism ,which elucidates how capitalism and patriarchal society treat women and nature. Moreover, it studies the effects of gender categories to show how social norms unfairly control women and the environment. This study explores how Tess Onwueme's Then She Said it dramatizes the combined tyranny of nature and women. It emphasizes the devastation caused by oil firms colluding with local authorities to exploit both. The playwright examines the historical oppression of Delta women and the environmental damage they endure, using dramatic visuals and dialogue to illustrate the harsh realities of pollution and poverty. This study examines the contradiction between the prosperity of oil companies and the po
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الانهار اصبحت مشبعة بثاني اوكسيد الكربون بشكل عالي وبذلك فهي تلعب دور مهم في كميات الكربون العالمية. لزيادة فهمنا حول مصادر الكربون المتوفرة في النظم البيئية النهرية، تم اجراء هذه الدراسة حول تأثير الكربون العضوي المذاب والحرارة (العوامل الرئيسية لتغير المناخ) كمحركات رئيسية لوفرة ثاني اوكسيد الكربون في الانهار. تم جمع العينات من خمسة واربعون موقع في ثلاثة اجزاء رئيسية لنهر دجلة داخل مدينة بغداد خلال فص
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Bedside clinical teaching is a fundamental part of the medical education that offers invaluable opportunities for the students to build and improve their clinical and communication skills. However, there is a growing concern about the increasing refusal of patients to participate in clinical sessions, especially in certain settings where there are sensitive cultural traditions and decreased trust in institutions.
This paper discusses patient refusal duri
In this paper, a simple fast lossless image compression method is introduced for compressing medical images, it is based on integrates multiresolution coding along with polynomial approximation of linear based to decompose image signal followed by efficient coding. The test results indicate that the suggested method can lead to promising performance due to flexibility in overcoming the limitations or restrictions of the model order length and extra overhead information required compared to traditional predictive coding techniques.
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This research study Blur groups (Fuzzy Sets) which is the perception of the most modern in the application in various practical and theoretical areas and in various fields of life, was addressed to the fuzzy random variable whose value is not real, but the numbers Millbh because it expresses the mysterious phenomena or uncertain with measurements are not assertive. Fuzzy data were presented for binocular test and analysis of variance method of random Fuzzy variables , where this method depends on a number of assumptions, which is a problem that prevents the use of this method in the case of non-realized.