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.
Fifteen local isolates of Pseudomonas were obtained from several sources such as soil, water and some high-fat foods (Meat, olives, coconuts, etc.). The ability of isolates to produce lipase was measured by the size of clear zone on Tween 20 solid medium and by measuring the enzymatic activity and specific activity. Isolate M3 (as named in this study) was found to be the most efficient for the production of the lipase with enzymatic activity reached 56.6 U/ml and specific activity of 305.94 U/mg. This isolate was identified through genetic analysis of the 16S rRNA gene. and it was shown that the isolate M3 belongs to Pseudomonas aeruginosa with 99% similarity. The DNA of isolate M3 was extracted and lipase gene was amplified through PCR tec
... Show MoreThe research specified with study the relation between the market share for the sample research banks and the amount of the achieved revenues from the investment, where the dominated belief that there potentiality enhancing the revenue on investment with the increase of the banks shares in their markets after their success in achieving rates of successive growth in their sales of sales and to a suitable achieve market coverage for their products and they have dissemination and suitable promotion activity, the market share represented the competition for the banks, and the markets pay attention to the market share as a strategic objective and to maintain them also increasi
... Show MoreThis research aims at answering many questions raised by the research problem concerning the view of the organizations under consideration for the concept of smart leadership and its most important dimensions, as well as the view of crisis management and its concept and most important methods through research objectives that define and clarify the smart leadership with its dimensions and methods of crisis management.
For the purpose of reaching the results of the research and testing the assumptions about the relationship between smart leadership and methods of crisis management, the researcher adopted a questionnaire, designed especially to be a criterion for the research, as the main tool for data coll
... Show MoreThe dubbing process for the Foreign Dramas by the Kurdish language became a serious phenomenon in the Kurdish satellite TV, especially in the past few years. It attracted a wide audience, especially young adolescents. And prepared by some breakthrough hostile to Kurdish culture and value coordinated by others remedy for the structural gaps and lapses have, as a result of climate which is brought into existence globalization and secretions variety dimensional, saturated value and cognitive effects bearing a strong identity of its elements. From here, the problem of this research is the ambiguity of their role in a series of developmental processes Kurdish awareness of young people and the extent of the impact that caused it.
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... Show MoreThis research is concerned with the re-analysis of optical data (the imaginary part of the dielectric function as a function of photon energy E) of a-Si:H films prepared by Jackson et al. and Ferlauto et al. through using nonlinear regression fitting we estimated the optical energy gap and the deviation from the Tauc model by considering the parameter of energy photon-dependence of the momentum matrix element of the p as a free parameter by assuming that density of states distribution to be a square root function. It is observed for films prepared by Jackson et al. that the value of the parameter p for the photon energy range is is close to the value assumed by the Cody model and the optical gap energy is which is also close to the value
... Show MoreAdolescence important and sensitive stage in social terms, being a stage where learns teenager bear social responsibilities and composition of their ideas about family life, as well as it is the stage where the teenager looking to himself for an important place in the community to become independent socially people, so it highlights the role of Social Work to do better effort and I believe him in order to prepare for the adolescent stage of adolescence and help him overcome the problems so that makes it adapts to the society in which he lives
The electoral mechanism is remarkably clear, a political tool for institutional construction, directing political life, forming the political scene, and forming the partisan scene. This process was through the design of electoral laws, as elections in Tunisian political history represented the indicator of its slow and accelerated transformations, so The elections in Tunisia usually coincide with important political stages, accompanied by legislative or constitutional amendments in general, Islamic or secular forces have played a fundamental role in promoting the democratic experience and the principle of the peaceful transfer of power. This led to the formation of a national consensus that would help the country not enter into political
... Show MoreEssential approaches involving photons are among the most common uses of parallel optical computation due to their recent invention, ease of production, and low cost. As a result, most researchers have concentrated their efforts on it. The Basic Arithmetic Unit BAU is built using a three-step approach that uses optical gates with three states to configure the circuitry for addition, subtraction, and multiplication. This is a new optical computing method based on the usage of a radix of (2): a binary number with a signed-digit (BSD) system that includes the numbers -1, 0, and 1. Light with horizontal polarization (LHP) (↔), light with no intensity (LNI) (⥀), and light with vertical polarization (LVP) (↨) is represen
... Show MoreElectrical resistivity tomography (ERT) methods have been increasingly used in various shallow depth archaeological prospections in the last few decades. These non‐invasive techniques can save time, costs, and efforts in archaeological prospection and yield detailed images of subsurface anomalies. We present the results of quasi‐three‐dimensional (3D) ERT measurements in an area of a presumed Roman construction, using a dense electrode network of parallel and orthogonal profiles in dipole–dipole configuration. A roll‐along technique has been utilized to cover a large part of the archaeological site with a 25 cm electrode and profile spacing, respectively. We have designed a new field proce