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 main idea of the financial censorship is to submit the states funds to a censorship because they are the funds of the people and because this censorship is a right and role ensured by the constitution for specific devices in the state, thus the role of the financial censor should be launched to achieve this goal in all walks of the state. • The power of this censorship depends basically on the independence of the censorious bodies over a job which is submitted to this censorship and the censor should have a reverence , this censorship is practiced as a precautionary procedure before preparing the budget to avoid mistakes after and during the execution for maintaining the states funds. • The importance of the censorship comes from
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Objective: the aim of this study is to determine the level of students' knowledge about the environmental health.
Methodology: The cross-sectional study was conducted at the College of Health and Medical Technology in Baghdad
city during the period from 1st march till 1st of July 2012. Data was collected by self-recording of a previously designed
questionnaire to obtain socio-demographic information such as (age, gender, department, year of grade).
Results: The highest rate of students were in the 2nd year followed by the 3rd year, highest rate of students had low
level of knowledge followed by intermediate level of knowledge, while lowest rate of students on had high level of
knowledge .Females had higher level of know
The primary function of commercial banks is the process of converting liquid liabilities such as deposits to illiquid assets, (also known as a loan), liquid assets, (aka cash and cash equivalent) in a balanced manner between liquid and illiquid assets, that guaranteed the preservation of the rights of depositors and the bank and not by converting liquid liabilities into liquid assets in a very large percentage. This comes from its role as depository and intermediary institutions between supply and demand, therefore, we find that the high indicators of bank liquidity and solvency may reflect a misleading picture of the status of commercial banks, to some extent in terms of the strength of their balance sheets and
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In order to achieve overall balance in the economy to be achieved in different markets and at one time (market commodity, monetary and labor market and the balance of payments and public budget), did not provide yet a model from which to determine the overall balance in the economy and the difficulty of finding the inter-relationship between all these markets and put them applied in the form of allowing the identification of balance in all markets at once.
One of the best models that have dealt with this subject is a model
(LM-BP-IS), who teaches balance in the commodity market and money market and balance of payments and the importance of this issue This research tries to shed light on the reality
The present theoretical study analyzes the legacy of the Chicago School of Urban Sociology and evaluates it in the light of the growth and development of Chicago City and the establishment of sociology in it. Sociology has become an academic discipline recognized in the United States of America in the late nineteenth century, particularly, after the establishment of the first department of sociology in the University of Chicago in 1892. That was during the period of the rapid industrialization and sustainable growth of the Chicago City. The Chicago School relied on Chicago City in particular, as one of the American cities that grew and expanded rapidly in the first two decades of the twentieth century. At the end of the nineteenth centur
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The study aims to identify the effects of dubbed Turkish drama on the public through the application of a sample of the views of women. The study also attempts to monitor the causes and motives due to the act of observation and to identify the various effects of this act. In order to achieve these goals, the researcher relies on the descriptive approach in addition to the questionnaire and interviews to collect data. It ends with a number of results such as: The study aims to identify the effects of dubbed Turkish drama on the public through the application of a sample of the views of women. The study also attempts to monitor the causes and motives due to the act of observation and to identify the various effects of this act. In ord
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Aim and Objectives: The objective of this study was to illustrate the link between periodontitis (PO) and endothelial dysfunction in hypertensive patients. Materials and Methods: This cross‑sectional study involved 53 hypertensive patients with or without PO compared with 28 healthy controls. On the basis of the study protocol, the participants were divided into three groups: Group (1): 24 patients with hypertension only, Group (2): 29 patients with hypertension and PO, and Group (3): 28 healthy controls. Lipid profile, endothelin‑1 (ET‑1), and high‑sensitivity C‑reactive protein (hs‑CRP) were measured. Blood pressure and body mass index (BMI) were evaluated. Diagnostic criteria of severe PO periodontal indices including plaque
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Each era has advantages in terms of innovation and development in form, technology, style, and design in ceramic vessels, both at the level of functional and aesthetic performance, so this study aimed to demonstrate the importance of geometrical foundations in the design structure of contemporary ceramic vessels, and also to reveal the constructive skills in The structure of the ceramic figure.
The researchers used the descriptive analytical approach to suit the nature of the study, and they described and analyzed the ceramic works in terms of geometric shape systems, elements and foundations of design in construction, formal diversity in the general design of ceramic vessels, and references and sources of artwork. In addition to th
The study included three topics, the definition of the personality of Imam al-Bazazi, his scientific biography, his elders, his writings, his students and his death, selected issues of his weightiness related to purity, and the Imam al-Bazazi is Muhammad ibn Muhammad ibnShihabibn Yusuf, known in al-Kardari al-Hanafi al-Balzazi. The other doctrines, the author relied in his book on the sources of the previous scholars of the Hanafis, and make them the basis in his book, the author did not adopt the definitions of language and terminology, and rarely mention the evidence Shariah adopted by scientists in their opinions, and limited to mention only opinions, In front of the first issue spotlessly water user, and the second issue that sleep l
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