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.
The increase of the scenographic designer role on account of the character of the director in the Iraqi theater constituted a clear phenomenon that has been manifested in many shows, which necessitated a stance on the nature of this relation and delimiting the work space for each one of them inside the theater show. The research focuses on determining the work relation between the directorial vision and the scenographic proposal in the Iraq theater show. The research is divided into four chapters, the first one addressed the methodological framework, where the research problem was stated in the following question (has the scenographic designer been able through his scenographic proposal to remove the director from his position being the
... Show More
The current research focuses on the extent to which the strategic orientation(entrepreneurial orientation, customer orientation, technology orientation, learning orientation, and investment orientation) affects the learning organization (building common vision, systemic thinking, personal dominance, mental models, team learning)The first hypothesis to test the connection relation between research variables and The second hypothesis was to test the relationship between these variables. In order to ascertain the validity of the hypotheses, the research was based on a questionnaire questionnaire prepared according to a number of In addition to building a fifth sub-variable for the strategic orientation (investment orientation) based
... Show More
(1)
(2)
Re-use of the byproduct wastes resulting from different municipal and industrial activities in the reclamation of contaminated water is real application for green projects and sustainability concepts. In this direction, the synthesis of composite sorbent from the mixing of waterworks and sewage sludge coated with new nanoparticles named “siderite” (WSSS) is the novelty of this study. These particles can be precipitated from the iron(II) nitrate using waterworks sludge as alkaline agent and source of carbonate. Characterization tests using X-ray diffraction (XRD), scanning electron microscopy (SEM) and energy dispersive spectroscopy (EDS) mapping revealed that the coating process was c
(43)
(36)
A sensitivity-turbidimetric method at (0-180o) was used for detn. of mebeverine in drugs by two solar cell and six source with C.F.I.A.. The method was based on the formation of ion pair for the pinkish banana color precipitate by the reaction of Mebeverine hydrochloride with Phosphotungstic acid. Turbidity was measured via the reflection of incident light that collides on the surface particles of precipitated at 0-180o. All variables were optimized. The linearity ranged of Mebeverine hydrochloride was 0.05-12.5mmol.L-1, the L.D. (S/N= 3)(3SB) was 521.92 ng/sample depending on dilution for the minimum concentration , with correlation coefficient r = 0.9966while was R.S.D%
... Show More
(9)
(7)
Background: Langerhans' cell histiocytosis (LCH) is a group of conditions affecting the reticuloendothelial system. It includes Letterer-Siwe disease, Hand-Schuller-Christian disease and eosinophilic granuloma and most often presents in childhood. Materials and methods: Twenty-five cases of LCH were diagnosed histologically and confirmed by CD1a antibody and assessed immunohistochemically using anti-RANKL and anti-RANK antibodies to evaluate osteoclastogenic mechanism. Results: Regarding jaw cases, there was a significant correlation between CD1a and RANK (P=0.016). While in the skull, highly significant correlation existed between RANK and RANKL (p=0.001). Among the sites, there was no statistically significant difference found for each
... Show More
(1)
The modern business environment has witnesses tremendous developments as a result of the globalization of markets and economic openness and technological as well as the acquisition of the issue of corporate governance of great importance regarding it as one of the global innovations trends of control provisions on the management of companies as result of these developments ,increasing on competition between economic unit ,thus a decrease in market share because they do not take into account the response to the requirements of customers ,which kept her to search a modern management accounting methods to help them keep up with the changes and the availability of information for the various adminis
... Show More
(1)
The aim of this study is to utilize the electromembrane extraction (EME) system as a manner for effective removal of zinc from aqueous solutions. A novel and distinctive electrochemical cell design was adopted consisting of two glass chambers, a supported liquid membrane (SLM) housing a polypropylene flat membrane infused with 1-octanol and a carrier. Two electrodes were used, a graphite as anode and a stainless steel as cathode. A comprehensive examination of several influential factors including the choice of carrier, the applied voltage magnitude, the initial pH of the donor solution, and the initial concentration of zinc was performed, all in a concerted effort to ascertain their respective impacts on the efficiency of zinc elim
... Show More
(5)
(2)
(57)
(53)
Abstract:
Musa son of Yaqoob son of Izra, the Spanish poet, linguist, and philosopher, was born in Granada. He has many poems representing types of poetry. Also, he had important books, such as "the Poetry of Israel" and "Contemplative Research". He is knowledgeable in both Hebrew and Arabic, because most of his books were written in Arabic and the then translated to Hebrew. It seemed that he was influenced by Arab poets, specifically Abo Firas, and borrowed many issues, such as comparison, repetition, exaggeration, etc. and included them in his poetry.
All know that Arabic literature clearly influenced Hebrew literature in the Spanish era. Ara
... Show More