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 absorption spectrum for three types of metal ions in different concentrations has been studying experimentally and theoretically. The examination model is by Gaius model in order to find the best fitting curve and the equation controlled with this behavior. The three metal ions are (Copper chloride Cu+2, Iron chloride Fe+3, and Cobalt chloride Co+2) with different concentrations (10-4, 10-5, 10-6, 10-7) gm/m3. The spectroscopic study included UV-visible and fluorescence spectrum for all different concentrations sample. The results refer to several peaks that appear from the absorption spectrum in the high concentration of all metal ions solution.
... Show MoreBackground: The world is in front of two emerging problems being scarceness of virgin re-sources for bioactive materials and the gathering of waste production. Employment of the surplus waste in the mainstream production can resolve these problems. The current study aimed to prepare and characterize a natural composite CaO-SiO2 based bioactive material derived from naturally sustained raw materials. Then deposit this innovative novel bioactive coating composite materials overlying Yttria-stabilized tetragonal zirconia substrate. Mate-rials and method; Hen eggshell-derived calcium carbonate and rice husk-derived silica were extracted from natural resources to prepare the composite coating material. The manufac-tured powder was characterized
... Show MoreThe purpose of this study is to show the constants and variables geography in Russian
policy in light of variables geostrategic witnessed by the world, especially after the collapse
of the Soviet Union and the disintegration to fifteen Republic became the Russian Federation
and the heir to the Soviet Union, Geography particularly important because the impact of its
data in policy making less change ofothers, and explain the political choices cannot achieve
security through its relationship constants geographical (natural or human) paint forms of
economic activity and determine the points they national security. issue is the geographical
this or that country is determined by its policy also specifies the way in which
Henrik Ibsen is considered one of the greatest writers on society and its problems in the modern era, as his works deal with society in all its forms in a realistic way, in which he presents the motives and consequences of social problems and their impact on society to study these problems through them to and propose solutions through theatre. Most of his writings were very serious about addressing these social issues. The method of collecting information in the study came through reviewing a group of sources related to realistic theater and social theory, then reading the plays covered in a critical and analytical reading. Based on that, the method of writing this study came and used a group of sources that directly relate to the s
... Show MoreUnconfined compressive strength (UCS) of rock is the most critical geomechanical property widely used as input parameters for designing fractures, analyzing wellbore stability, drilling programming and carrying out various petroleum engineering projects. The USC regulates rock deformation by measuring its strength and load-bearing capacity. The determination of UCS in the laboratory is a time-consuming and costly process. The current study aims to develop empirical equations to predict UCS using regression analysis by JMP software for the Khasib Formation in the Buzurgan oil fields, in southeastern Iraq using well-log data. The proposed equation accuracy was tested using the coefficient of determination (R²), the average absolute
... Show MoreBackground: A Temporomandibular joint (TMJ) internal derangement (TMJID) is a disruption within the internal aspects of the TMJ in which the disc is displaced from its normal functional relationship with the mandibular condyle, after which the articular portion of the temporal bone causes joint dysfunction, joint sound, malocclusion, and locking of the mouth. Conservative and invasive techniques can be used for the treatment of TMJID. A platelet-rich plasma (PRP) injection is a simple, less invasive surgical procedure for the treatment of internal derangement. The objective of this study was to evaluate the efficacy of PRP injections in decreasing or eliminating pain, clicking, and limitation of mouth opening in patients with TMJID after th
... Show MoreOnomatopoeia has always been a functional poetic device which enjoys a high sound significance in the poetry of many languages. In modern English and Arabic poetry alike, it proves to be vital and useful at different levels: musical, thematic and at the level of meaning. Still, the cultural difference looms large over the ways it is employed by the poets of each. The present paper investigates the employment of onomatopoeia in the poetry of D. H. Lawrence (1885-1930) and Badr Shakir al-Sayyab (1926-1964) who are chosen due to the importance they enjoy in modern English and Arabic poetry and the richness of their poems in onomatopoeias. The conclusions reached at are in a sense related to cultural differences which govern the use of onomato
... Show MoreBackground: The purposes of this study were to determine the photogrammetric soft tissue facial profile measurements for Iraqi adults sample with class I normal occlusion using Standardized photographic techniques and to verify the existence of possible gender differences. Materials and methods: Eighty Iraqi adult subjects (40 males and 40 females) with an age ranged between 18-25 years having class I normal occlusion were chosen for this study. Each individual was subjected to clinical examination and digital standardized right side photographic records were taken in the natural head position which is mirror position which the patient looking straight into his eyes into the mirror mounted on the stand. The photographs were analyzed using A
... Show More