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.
Abstract In light of the changing conditions that prevail in society, and the intense competition that institutions and countries are forced to face, especially after the opening of markets, and the transformation of the world into what is called a small village, entrepreneurship has emerged as an important tool for dealing with the developments of societies, whether it is related to individual business projects or Economics for national business, leadership was the key to any driving force towards achieving growth. Today, women are no longer captive to a specific orientation, but rather all horizons and fields of work have been opened to them, and they have been able to occupy the most important economic, voluntary, service, and
... Show MoreA detailed study of adsorption from solution of amitriptyline-HCl, chlorpromazine-HCl and
chlordiazepoxide-HCl on bentonite clay surface has been performed at variable conditions of
temperature, pH and ionic strength. It is aimed in this work to explore the capability of this clay in
treatment of poisoning by the mentioned drugs if taken in quantities higher than the usual doses.
Quantities of drugs adsorbed have been determined by UV spectrophotometric technique. The
sequence of adsorption in neutral media at 37.5 CÙ’ followed the order:
Amitriptyline-HCl > chlorpromazine-HCl > chlordiazepoxide-HCl.
The results were discussed in the light of Langmuir and Freundich adsorption isotherms. The usual
basic th
Through the early childhood and after the ablactating the child learns acquired food habbits that might studying with him throughout his life. Here the parents role arises: teaching the child the sound food habits and hygienic styles and whatever beneficial to the health and with the sufficient quantities for the body. In this way the experiences the child learns at home will be of great help in his future life in choosing the suitable food after becoming more dependent in making his decisions and choices away from his parents. The results in this study showed that the averages of the children’s consumption of the high energy foods in comparison with the other highest consumption average , after that comes the con sumption of soft drills
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Background: This study was conducted to assess the effect of sonic activation and bulk placement of resin composite in comparison to horizontal incremental placement on the fracture resistance of weakened premolar teeth. Materials and method: Sixty sound human single-rooted maxillary premolars extracted for orthodontic purposes were used in this study. Teeth were divided into six groups of ten teeth each: Group 1 (sound unprepared teeth as a control group), Group 2 (teeth prepared with MOD cavity and left unrestored), Group 3 (restored with SonicFill™ composite), Group 4 (restored with Quixfil™ composite), Group 5 (restored with Tertic EvoCeram® Bulk Fill composite) and Group 6 (restored with Universal Tetric EvoCeram® co
... Show MoreObjectives: The research aims to highlight the semiotic approach and apply it to a photograph of the Pope's reception at Baghdad International Airport, published on the page of the Media Office of Iraqi Prime Minister Mustafa Al-Kazemi in the Twitter application, in order to study its components, analyze its contents and clarify its implications, as well as approach the image as a political and media act. Methods: The stages of research were accomplished by "investigation, observation, and analysis", and the dismantling of the composition of the photograph, thus revealing the hidden and hidden aspects, relying on the semiotic approach to analysis. Results: The study showed that the ideas and meanings included in the image in form
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يهدف هذا البحث الى التطرق الى صورة العربي كما يعرضها ادب اليافعين العبري في رواية " نادية " للكاتبة العبرية " كاليلا رون فيدر " . والتي تعد من الاديبات العبريات اللواتي تطرقن بصورة مباشرة الى موضوع ما خلف الجدار ، والصراع العربي – الإسرائيلي وانعكاساته على المجتمع الإسرائيلي بصورة عامة والمجتمع العربي بصورة خاصة . ينقسم هذا البحث إلى ثلاثة فصول، تطرق الفصل الأول إلى "ادب اليافعين"، و تاريخه ، مميزاته والفئ
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Background: The marginal adaptation has a key role in the success and longevity of the fixed dental restoration, which is affected by the impression and the fabrication techniques .The objective of this in vitro study was to evaluate and compare the marginal fitness of lithium disilicate crowns using two different digital impression techniques (direct and indirect techniques) and two different fabrication techniques (CAD/CAM and Press techniques). Materials and Methods: Thirty two sound upper first premolar teeth of comparable size extracted for orthodontic reason were selected in this study .Standardized preparation of all teeth samples were carried out with modified dental surveyor to receive all ceramic crown restoration with 1 mm deep
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Type 2 diabetes mellitus(T2DM) is a metabolic disease that is associated with an increased risk for atherosclerosis by 2-4 folds than in non- diabetics. In general population, low IGF-1 has been associated with higher prevalence of cardiovascular disease and mortality .This study aims to find out the relationship between IGF-1 level and other biochemical markers such as Homeostasis Model Assessment insulin resistance(HOMAIR) and Body Mass Index(BMI) in type 2 diabetic patients . This study includes (82) patients (40 females and 42 males) with age range (40-75) years,(34) non obese diabetic patients and (48) obese diabetic patients. The non obese individuals considered
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Abstract
This paper discusses the essence of the developmental process in auditing firms and offices at the world today. This process is focused on how to adopt the audit concepts which is based on Information and Communication Technology (ICT), including the Continuous Auditing (CA) in particular. The purpose of this paper is to design a practical model for the adoption of CA and its requirements according to the Technology Acceptance Model (TAM). This model will serve as a road map for manage the change and development in the Iraqi auditing firms and offices. The paper uses the analytical approach in reaching to the target results. We design the logical and systematic relations between the nine variable
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