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.
Emotions are part of the personality of the individual and affect many different aspects of the personality, and it is an important element of social and psychological adaptation, especially if it is within the limits of nature, and if the methods used to express them are appropriate and moderate.
Submission is one of the characteristics that express the way an individual relies upon in dealing with others and in dealing with matters of life. An individual who complies with instructions and orders and abides by them, and performs what is required of him without hesitation or delay. Adolescence is an important and accurate stage in the constructive development of an individual and in his psychological and social life.
The
... Show MoreThe tagged research (realism in the Paintings of Iraqi Kurdistan artists, “a study of expression methods”) dealt with realism in an objective way, as well as the complexity of its concepts through its formations and formations. On realism and its historical dimension in concept and meaning, as for the second chapter, the research was focused on the methods of expression in painting, while the third chapter was concerned with the procedural applications of realistic methods of expression in the drawings of Iraqi Kurdistan, and according to these axes and to achieve the goal of the research, a number of Among the results are:
1- Realism documented the life of the Kurdish society in line with the developments of the era, as the sty
Various simple and complicated models have been utilized to simulate the stress-strain behavior of the soil. These models are used in Finite Element Modeling (FEM) for geotechnical engineering applications and analysis of dynamic soil-structure interaction problems. These models either can't adequately describe some features, such as the strain-softening of dense sand, or they require several parameters that are difficult to gather by conventional laboratory testing. Furthermore, soils are not completely linearly elastic and perfectly plastic for the whole range of loads. Soil behavior is quite difficult to comprehend and exhibits a variety of behaviors under various circumstances. As a result, a more realistic constitutive model is
... Show MoreBackground: Type two diabetic patients have higher risk of cardiovascular and periodontal disease. Furthermore, patients with more severe periodontal disease have higher incidence of cardiovascular disease. This study aimed to assess the association between periodontal health status and the risk of vascular disease in type 2 diabetic patients. Materials and Methods: One hundred type 2 diabetes mellitus patients and fifty apparently healthy males were enrolled in this study. Oral examinations conducted were; plaque Index, calculus index, gingival index, probing pocket depth, and clinical attachment level. For the assessment of vascular risk, arterial stiffness index was used. Results: According to arterial stiffness index, type 2 diabetic p
... Show MoreAsthma is a chronic inflammatory disease of respiratory airways characterized by distinctive history of respiratory symptoms due to variable airflow obstruction which reverses either spontaneously or in response to certain medications. Acetylcholine is a parasympathetic neurotransmitter which plays fundamental roles in the development of persistent asthma. Treatment guidelines recommend using medium doses of inhaled corticosteroids in addition to another controller bronchodilator instead of using high doses inhaled steroid alone for treatment of moderate to severe persistent asthma. The inhaled long acting muscarinic antagonist, tiotropium, was approved recently to control unresponsive asthma to inhaled corticosteroid with or without a long
... Show MoreVarious simple and complicated models have been utilized to simulate the stress-strain behavior of the soil. These models are used in Finite Element Modeling (FEM) for geotechnical engineering applications and analysis of dynamic soil-structure interaction problems. These models either can't adequately describe some features, such as the strain-softening of dense sand, or they require several parameters that are difficult to gather by conventional laboratory testing. Furthermore, soils are not completely linearly elastic and perfectly plastic for the whole range of loads. Soil behavior is quite difficult to comprehend and exhibits a variety of behaviors under various circumstances. As a result, a more realistic constitutive model is
... Show MoreThis study aimed to incorporate hydroxyapatite nanoparticles (nHA) or amorphous calcium phosphate nanoparticles (nACP) into a self-etch primer (SEP) to develop a simplified orthodontic bonding system with remineralizing and enamel preserving properties.
nHA and nACP were incorporated into a commercial SEP (Transbond™ plus) in 7% weight ratio and compared with the plain SEP as a control. Shear bond strengths (SBS), enamel damage, and adhesive remnant index (ARI) scores were evaluated at 24 h
Within this work, to promote the efficiency of organic-based solar cells, a series of novel A-π-D type small molecules were scrutinised. The acceptors which we designed had a moiety of N, N-dimethylaniline as the donor and catechol moiety as the acceptor linked through various conjugated π-linkers. We performed DFT (B3LYP) as well as TD-DFT (CAM-B3LYP) computations using 6-31G (d,p) for scrutinising the impact of various π-linkers upon optoelectronic characteristics, stability, and rate of charge transport. In comparison with the reference molecule, various π-linkers led to a smaller HOMO–LUMO energy gap. Compared to the reference molecule, there was a considerable red shift in the molecules under study (A1–A4). Therefore, based on
... Show More<p>In combinatorial testing development, the fabrication of covering arrays is the key challenge by the multiple aspects that influence it. A wide range of combinatorial problems can be solved using metaheuristic and greedy techniques. Combining the greedy technique utilizing a metaheuristic search technique like hill climbing (HC), can produce feasible results for combinatorial tests. Methods based on metaheuristics are used to deal with tuples that may be left after redundancy using greedy strategies; then the result utilization is assured to be near-optimal using a metaheuristic algorithm. As a result, the use of both greedy and HC algorithms in a single test generation system is a good candidate if constructed correctly. T
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