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.
The nature of the political system of any country in the international system must have an impact on the policy of the State, whether in the interior or exterior, both regional and international, Turkey is one of the most important countries in the Middle East, which have a place and effectiveness on the surrounding environment, hence the importance of research lies in its political system and the transfer of power in it and its transformation from the form of the parliamentary system to the presidential system of the repercussions of the task and mutual effects between Turkey and the countries of the surrounding region in terms of the extent of achieving political stability in the Turkish interior or not and how this can be refl
... Show MoreOsmotin and osmotin-like proteins belong to the PR-5 pathogenesis-related group of proteins and are induced in response to various types of biotic and abiotic stresses in several plant species. Carrot was transformed with a tobacco osmotin gene that encodes a protein lacking the vacuolar-sorting motif that is composed of a 20-amino-acid sequence at the C-terminal end, under the control of the cauliflower mosaic virus 35S promoter, using Agrobacterium-mediated transformation. Transgene integration and expression were confirmed by Southern and western blot analyses, and three selected transgenic lines were evaluated for their ability to tolerate drought stress. Under drought stress conditions, all transformants exhibited slower rates of wilti
... Show MoreKinetics study on the phenol oxidation by catalytic wet air oxidation (CWAO) using CuO.NiO/Al2O3 as heterogeneous catalyst is presented. 4 g/l phenol solution of pH 7.3 was oxidized in a trickle bed reactor with gas flow rate of 80% stochiometric excess (S.E).. In order to verify the proposed kinetics, a series of CWAO experimental tests were done at two temperatures (140 and 160° C), oxygen partial pressures (9 and 12 bar), and weight hourly space velocity (WHSV) (1, 1.5, 2, 2.5, and 3 h-1). According to Power Law, the reaction orders are found to be approximately 1 and 0.5 with respect to phenol concentration and oxygen solubility, respectively. These values favorably compare with those cited in the literature for intrinsic kinetics,
... Show MoreOrthodontic wires facilitate the required dental adjustments in the context of orthodontic therapy. The archwire has played a crucial role in orthodontic treatment, and the increasing emphasis on aesthetic preferences from patients, as well as the development of composite and ceramic brackets, have prompted investigations into aesthetic archwires that complement these brackets. Orthodontic wires are produced using a diverse range of materials. The utilisation of all available wire types can improve patient comfort, decrease chairside time, and shorten the overall duration of treatment. The individual clinician must possess comprehensive knowledge and comprehension of the various requirements and alternatives throughout the therapeut
... Show MoreA characteristic study of a passively Q-switched diode pumped solid state laser system is presented in this work. For laser a comparison study for the theoretically calculated results with a simulation results using a software which calculates the Q-switched solid state laser parameters was such as energy, peak power and pulse width were performed. There was a good agreement between our theoretical calculations and the simulation values.
Recommender Systems are tools to understand the huge amount of data available in the internet world. Collaborative filtering (CF) is one of the most knowledge discovery methods used positively in recommendation system. Memory collaborative filtering emphasizes on using facts about present users to predict new things for the target user. Similarity measures are the core operations in collaborative filtering and the prediction accuracy is mostly dependent on similarity calculations. In this study, a combination of weighted parameters and traditional similarity measures are conducted to calculate relationship among users over Movie Lens data set rating matrix. The advantages and disadvantages of each measure are spotted. From the study, a n
... Show MoreRutting has a significant impact on the pavements' performance. Rutting depth is often used as a parameter to assess the quality of pavements. The Asphalt Institute (AI) design method prescribes a maximum allowable rutting depth of 13mm, whereas the AASHTO design method stipulates a critical serviceability index of 2.5 which is equivalent to an average rutting depth of 15mm. In this research, static and repeated compression tests were performed to evaluate the permanent strain based on (1) the relationship between mix properties (asphalt content and type), and (2) testing temperature. The results indicated that the accumulated plastic strain was higher during the repeated load test than that during the static load tests. Notably, temperatur
... Show MoreAbstract The study aimed at demonstrating the reality of sectarian coexistence in Iraq, which was characterized by the tolerance and coercion caused by the successive government policies to govern Iraq and to this day. The study was based on the hypothesis that coexistence between Islamic sects in Iraq can be achieved as long as there are strong bonds linking its components, and these bonds can produce coexistence between the sects based on peace. The study concluded that the hypothesis is correct, in addition to drawing a set of observations aimed at identifying weaknesses for advancing them through the adoption of mechanisms that address these weaknesses to yield towards a genuine peaceful coexistence among Islamic sects in Iraq.
The problem of the research is focused on importance limited of Iraq industrial companies in application of scientific measurements of supply chains performance, The research sought to achieve a group of goals, the most important are , identifying the strengths and weaknesses in the reality of supply chain in General Company for Cotton Industries, The data and information required are gathered from the dependence company, records through the field observations and personal interviews, the research used some quantitative indicators to measure of supply chain performance, The research reached to many conclusions , the most outstanding among them is the existence of a strong inverse correlatio
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