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 surgeryKeywords: Non-surgical treatment of anal fissure, fissure in ano, sphicterotomy,botulinum toxin in anal fissures, glyceryl trinitrate. Chemical sphincteratomy, pharmacological sphincteratomy.
This paper studies the demonstratives as deictic expressions in Standard Arabic and English by outlining their phonological, syntactic and semantic properties in the two languages. On the basis of the outcome of this outline, a contrastive study of the linguistic properties of this group of deictic expressions in the two languages is conducted next. The aim is to find out what generalizations could be made from the results of this contrastive study.
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Purpose/objective:
1 - To explain the financial impact of the activities and areas of human resources management and the adoption of the methodology for estimating costs on the basis of conduct and statement of how to assess costs and benefits of human resource activities.
2 - Measuring human capital, and its impact on the financial statements.
Design/methodology/approach:
Concentrated dimensions of the research paper's lack of financial statements prepared by the organizations for information mandated human resource its components of the three (attraction - development
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Spergularia iraqensis sp. nov. is described as a new species from Iraq. This species has been collected from Diyala Province in the central east of Iraq; it is closely related to Spergularia rubra (L.) J. Presl & C. Presl, 1819 and Spergularia bocconei (Scheele) Graebn., 1919.
The distinguishing of the morphological characteristics of the new species alongside the two similar species are discussed with photographs, and an identification key is given for Spergularia iraqensis and other closely related species.
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Recently times, industrial development has increased, including plastic industries, and since plastic has a very long analytical life, it will cause environmental pollution. Therefore studies have resorted to reusing recycled plastic waste (sustainable plastic) to produce environmentally friendly concrete (green concrete). In this research, some studies were reviewed and then summarized into several things, including the percentage of plastic replacement from the aggregate and the effect of this percentage on the fresh properties of concrete, such as the workability and the effect of plastic waste on the hardening properties of concrete such as dry density, compressive, tensile and flexural strength.
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