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.
Taurodontism is a rare developmental dental anomaly marked by apical displacement of the pulpal floor, enlarged pulp chambers, and root bifurcation or trifurcation near the apex. Its etiology involves genetic mutations, syndromic associations, or developmental disturbances of Hertwig’s epithelial root sheath. Diagnosis relies mainly on radiographic assessment, with CBCT offering superior accuracy, and indices such as Shaw’s and Shifman’s aiding classification. Clinically, taurodontism complicates endodontic, surgical, orthodontic, and restorative procedures and may indicate underlying systemic disorders. Early recognition and interdisciplinary planning are crucial to optimizing patient outcomes. DOI: ht
... Show MoreThis research aimed to diagnose the perception based on Telecommunications of Iraq to the importance of activating knowledge management marketing in possession, as well as Indication of impediments to activate the management of marketing knowledge in the researched companies, also aimed to show the extent of the existence of significant differences in perception based on Telecommunications Iraqi importance of activating the management marketing knowledge in possession. To achieve the objectives of this research, the questionnaire was developed and distributed to a sample of telecommunications companies in the city of Sulaimaniya, was selected on the criterion according to the company's life in terms of seniority in the telecommunication
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In this paper, a robust adaptive sliding mode controller is designed for a mobile platform trajectory tracking. The mobile platform is an example of a nonholonomic mechanical system. The presence of holonomic constraints reduces the number of degree of freedom that represents the system model, while the nonholonomic constraints reduce the differentiable degree of freedom. The mathematical model was derived here for the mobile platform, considering the existence of one holonomic and two nonholonomic constraints imposed on system dynamics. The partial feedback linearization method was used to get the input-output relation, where the output is the error functions between the position of a certain point on the platform
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The aim of this paper is to translate the basic properties of the classical complete normed algebra to the complete fuzzy normed algebra at this end a proof of multiplication fuzzy continuous is given. Also a proof of every fuzzy normed algebra without identity can be embedded into fuzzy normed algebra with identity and is an ideal in is given. Moreover the proof of the resolvent set of a non zero element in complete fuzzy normed space is equal to the set of complex numbers is given. Finally basic properties of the resolvent space of a complete fuzzy normed algebra is given.
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KE Sharquie, JR Al-Rawi, AA Noaimi, MM Jabir, Iraqi Postgraduate Medical Journal, 2009
This paper is concerned with introducing and studying the new approximation operators based on a finite family of d. g. 'swhich are the core concept in this paper. In addition, we study generalization of some Pawlak's concepts and we offer generalize the definition of accuracy measure of approximations by using a finite family of d. g. 's.
S Khalifa E, AR Jamal R, N Adil A, J Munqithe M…, 2009
The substantial key to initiate an explicit statistical formula for a physically specified continua is to consider a derivative expression, in order to identify the definitive configuration of the continua itself. Moreover, this statistical formula is to reflect the whole distribution of the formula of which the considered continua is the most likely to be dependent. However, a somewhat mathematically and physically tedious path to arrive at the required statistical formula is needed. The procedure in the present research is to establish, modify, and implement an optimized amalgamation between Airy stress function for elastically-deformed media and the multi-canonical joint probability density functions for multivariate distribution complet
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Technique was used to retail for analyzing atom beryllium ion cathode of an atom lithium to six pairs of functions wave which two ?????? and the rest of the casing moderation and to analyze atom lithium ion Mob atom beryllium to three pairs of functions wave pair of casing and the rest of the casing moderation using function wave Hartree Fock and each casing email wascalculate expected values ??....