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.
At the beginning of the nineties increased responsibility of the auditor to the community as the demand for auditing the environmental performance for the economic units in addition to audit the financial performance. With the aim of preserving the environment and reducing the damagse as aresult of the negative effects of the activities of these units.
The researh deal with two sides the first one identifies the theoretical framework of the concept of environmental audits, requirements, methods, types of procedures, and duties of the auditor in conducting environmental audits. It also deals with the concept of the enviro
... Show MoreThe current research focuses on the extent to which the strategic orientation(entrepreneurial orientation, customer orientation, technology orientation, learning orientation, and investment orientation) affects the learning organization (building common vision, systemic thinking, personal dominance, mental models, team learning)The first hypothesis to test the connection relation between research variables and The second hypothesis was to test the relationship between these variables. In order to ascertain the validity of the hypotheses, the research was based on a questionnaire questionnaire prepared according to a number of In addition to building a fifth sub-variable for the strategic orientation (investment orientation) based
... Show MoreThe increase of the scenographic designer role on account of the character of the director in the Iraqi theater constituted a clear phenomenon that has been manifested in many shows, which necessitated a stance on the nature of this relation and delimiting the work space for each one of them inside the theater show. The research focuses on determining the work relation between the directorial vision and the scenographic proposal in the Iraq theater show. The research is divided into four chapters, the first one addressed the methodological framework, where the research problem was stated in the following question (has the scenographic designer been able through his scenographic proposal to remove the director from his position being the
... Show MoreContinuous turbidimetric analysis (CTA) for a distinctive analytical application by employing a homemade analyser (NAG Dual & Solo 0-180°) which contained two consecutive detection zones (measuring cells 1 & 2) is described. The analyser works based on light-emitting diodes as a light source and a set of solar cells as a light detector for turbidity measurements without needing further fibres or lenses. Formation of a turbid precipitated product with yellow colour due to the reaction between the warfarin and the precipitation reagent (Potassium dichromate) is what the developed method is based on. The CTA method was applied to determine the warfarin in pure form and pharmaceu
A series of Schiff base-bearing salicylaldehyde moiety compounds (1-4) had been designed, synthesized, subjected to insilico ADMET prediction, molecular docking, characterization by FT-IR, and CHNS analysis techniques, and finally to their Anti-inflammatory profile using cyclooxygenase fluorescence inhibitor screening assay methods along with standard drugs, celecoxib, and diclofenac. The ADMET studies were used to predict which compounds would be suitable for oral administration, as well as absorption sites, bioavailability, TPSA, and drug likeness. According to the results of ADME data, all of the produced chemicals can be absorbed through the GIT and have passed Lipinski’s rule of five. Through molecular docking with PyRx 0.8, these
... Show MoreThe efficiency of Nd:YAG laser radiation in removing debris and smear layer from prepared root
canal walls was studied. Fifty-seven human extracted single rooted anterior teeth were divided into three
groups. A group that was not lased is considered as a control group. The remaining teeth were exposed to
different laser parameters regarding laser energy, repetition rate and exposure time. For the case of the set of
parameters of 7 mJ laser energy, the cleaning was maximum at 3 p.p.s. repetition rate for 3 seconds exposure
time for, the coronal, middle and apical thirds. Above and below this energy level, there was an overdose
(melting) or under dose (no effect). Nevertheless for 10mJ laser energy case, the cleaning effi
This study aims to identify the impact of social support on breast cancer patients’ psychological rigidity using a sample in Ramallah and al-Bireh. A descriptive correlative approach was adopted to fulfill the goals of the study and a questionnaire consisted of two criteria: social support and psychological rigidity, which was adopted as a tool for data collection for the study. In order to achieve the goals of the study, the researcher selected a convenient sample that consisted of 123 female breast cancer patients in Ramallah and al-Bireh. This sample represented 50% of the original patient population. The study showed that the average estimated percentage of social support and psychological rigidity for women with breast cancer, in
... Show MoreShort Multi-Walled Carbon Nanotubes functionalized with OH group (MWCNTs-OH) were used to synthesize flexible MWCNTs networks. The MWCNTs suspension was synthesized using Benzoquinone (BQ) and N, N Dimethylformamide alcohol (DMF) in specific values and then deposited on filter paper by filtration from suspension (FFS) method. Polypyrrole (PPy) conductive polymer doped with metallic nanoparticles (MNPs) prepared using in-situ chemical polymerization method. To improve the properties of the MWCNTs networks, a coating layer of (PPy) conductive polymer, PPy:Ag nanoparticles, and PPy: Cu nanoparticles were applied to the network. The fabricated networks were characterized using an X-ray diffractometer (XRD), UV-Vis. spectrometer, and Ato
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