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 problem of research was the lack of research that dealt with issue of the job design approach that is more suitable for knowledge work, therefore, the research aims to determine the impact of job enrichment, and knowledge capitalon strategic success, starting from the hypothesis that there significant impact of job enrichment and knowledge capital on strategic success, to achieve this goal the researchers from the theoretical literature and related studies conclude to the construction of the scheme shows the hypothetical relationship between the variables, which was adopted job enrichment as independent variable while knowledge capital plays two roles, the first as an independent variable and the second as an intermediate
... Show More- coli K12 and B. subtilis 168 were investigated for their cadmium and mercury tolerance abilities. They were developed by UV mutagenesis technique to increase their tolerances either to cadmium or mercury, and their names then were designated depend on the name and concentration of metals. E. coli K12 Cd3R exhibited bioremediation amount of 6.5 mg Cd/g dry biomass cell. At the same time, its wild-type (E. coli K12 Cd3) was able to remove 5.2 mg Cd/g dry biomass cell in treatment of 17 mg Cd /L within 72 hours of incubation at 37 °C (pH=7) in vitro assays. The results show that E.coli K12 Hg 20 was able to remove 0.050 µg Hg/g dry biomass cell
There are many studies that discussed the famous museum's graveyards in the Islamic worlds, to study the lives of these figures, there are many difficulties for their studies because the first we need the regularity and history information, and many sciences support, such as in language, geography information.
I am studying the research from Maraqid Al-Maaraf book by Harz Aldeen, the book has large members about the persons have graved in Persian Country in the middle ages, there are more than (30) figures in my study, I have studied every figure in this research depending on the sources and references books.
The habitat type and food availability always influence the population size of many
organisms. Bird’s feeding pattern should be abstracted to complete avian community structure
data. The agronomy main research farm of Orissa University of Agriculture and Technology
is a well-managed multi-crop agro-ecosystem which provides a suitable ground for ecological
research. In a multi-crop farmland, the association of Barn Swallow Hirundo rustica Linnaeus,
1758, with the Indian mustard Brassica juncea (L.) Czernajew, 1859 crops have been
recorded for the first time while hovering only on this field. A flock of Barn swallows was
recorded in 32 field visits while flying continuously over the Indian mustard field after
flow
The capital banking foundation stone upon which the bank in the practice of business activities, the more capital a good financial adequacy of the increased bank's ability to grant credit and expand the various activities and provide a safety element for depositors and other sources of funding to achieve profits and increase the trading volume of the shares, causing the rise the rate of return for the shares of banks and have the Central Bank as head of the banking system by issuing instructions capital increase banking, according to the requirements of economic development and increase gross domestic product by supporting investment projects that are financed through banks, the research aims to show the extent of the banks commitment to
... Show MoreBackground: With the increase in composite material use in posterior teeth, the concerns about the polymerization shrinkage has increased with the concerns about the formation of marginal gaps in the oral cavity environment. New generation of adhesives called universal adhesive have been introduced to the market in order to reduce the technique sensitive bonding procedures to give the advantage of using the bonding system in any etching protocol without compromising the bonding strength. The aim of the study was to study marginal adaptation of two universal adhesives (Single bondâ„¢ Universal and Prime and Bond elect) using 3 etching techniques under thermal cycling aging. Materials and Methods: Forty-eight sound maxillary first premola
... Show MoreThis study focused on a fundamental issue which was represented by ability of Iraqi central bank in facing the difficulty of determining the optimal ratio of liquidity in the Iraqi banks in terms of the balancing between its obligations to the depositors and borrowers, and liquidate their funds on one hand and the risks on the other hand.the search aimed for achieving the goals which represented by identifying the possibility of Iraqi banks to apply the regulations rules and instructions issued by central bank of Iraq in determining ratio of liquidity and its appropriate with Iraqi banks action to implement a reasonable profit to&
... Show MorePublic budget is the government's tool in achieving the objectives of economic and social development is the accounting curriculum to estimate state revenues and expenditures for years to come, as well as to have legal status as it is after the adoption of an official statement of government units to spend funds on items planned at the same time is a statement collect resources to finance these appropriations, if the primary objective of the budget initially limited to the achievement of financial and legislative control have evolved this function in the area of public administration turned attention from mere imposition of control over the money, which provides information to assist the Department to utilize available resources and prog
... Show MoreThe sport of polo, the game of kings and sultans, is one of the traditional sports that has defied time throughout its long history. It has preserved its historical roots and been able to adapt to contemporary requirements, societal transformations, and temporal and spatial variables. It has moved from an aristocratic sport practiced as a form of entertainment to a professional competitive sport. It attracts many players and millions of viewers, so it is a living model of how sports develop and transform from a local tradition into global sports with organized rules managed by international institutions and with many championships worldwide. Through this, the research objectives were formulated, including exploring sports' origins. Polo in
... Show MoreIn Iraq, government contributions to the public companies have become a very important aspect which contributes to the survival and sustainability of these institutions as it consider one of the main sources of funding, if not it consider the basis of funding.
According to the vital roles assigned to these institutions to follow up, which usually include important activities in the national economy, the research focused on studying the field reality of the method used in evaluating the stock of total production and purchases of goods for the purpose of selling the strategic commodities of the General Company for Grain Trade. As a result, the aim of this study came to came to highlight&n
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