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.
Iranian stories have been one of the most important aspects of Iranian society's culture and have reflected us as a mirror of all its cultural, societal and political dimensions.Among the important elements of the story can be the creation of space and the movement and the creation of characters and conflict and content and the angle of vision and landscape, language and subject. Studying the elements of the story leads to more understanding and determining the strength and skill of the author by studying the elements of his story. The story of Rustom and Suhrab is also one of the many stories in which the elements of the story are often noticed and show the skill of the great professor Al-Fardousi to benefit from these eleme
... Show MoreBackground: The aim of this in vitro study was to evaluate and compare the microleakage between Vertise Flow T M composite material and other conventional (Filtek Z250, riva light cure and SDR) composite materials when restoring CII mesial box only cavity at gingival margin through die penetration test Materials and methods: Forty maxillary first premolars were prepared with class II box design only cavities. Samples were divided into four groups of ten teeth according to material used: group I (FiltekZ250 only). Group II (SDR+FiltekZ250). Group III (Vertise Flow +FiltekZ250). Group IV (Riva light cure+ FiltekZ250). After 24 hrs. immersion in 2% in methylene blue, samples were sectioned and micro leakage was estimated. Results: None of the
... Show MoreIn the age of information and communication revolution, education as one of life aspects has influenced with that revolution by integrating technology in education, which have become as an important learning tools of the whole educational process . Technology, when used appropriately, can help make science classroom a site of active learning and critical thinking, furthering student inquiry and connections with different materials. It is necessary to develop human rights education programs and materials for discretionary and extracurricular activities as it provide them with the skills and tools so that they are empowered to take action to realize their rights. Human rights education is a critical means of instilling the knowledge، skil
... Show MoreThe primary objective of root canal therapy is adequate biomechanical preparation of root canal system followed by 3D obturation.in clinics we are encountered with several anatomical variations, which we need to manage efficiently. One of the major factors responsible for failure of root canal therapy is missed canals. Recent technological advances have given the clinician opportunity to identify anatomical variations and treat them to satisfaction.
Allowing Iraqi companies to use multiple systems and policies leads to varying levels of disclosure and no high symmetry between report preparers and users, and that the adoption of integrated reporting can reduce information asymmetry. The theoretical side addressed the concepts of these variables, and in the practical side the binary variable (0, 1) was used. To compensate for the value of the independent variable (integrated reporting) based on the Central Bank of Iraq’s classification of banks according to the (CAMLES) index, and the dependent variable (information asymmetry) was measured through two measures (price difference, unusual return), the research community was represented by (5) Banks out of the total of banks li
... Show MoreThe current research aims to :
•know the level of social intelligence of the sample as a whole .
. •taraf statistically significant differences in social intelligence between disadvantaged and
non-disadvantaged peers .
To achieve these objectives, the selected sample of Talbhalmrahlh medium and specifically
students of the second grade average, were chosen randomly stratified's (360) students
included sex (male, female) and (deprived of the Father and the non-deprived) for the
academic year (2013-2014) for the province of Baghdad on both sides (Rusafa-Karkh (
As applied to them measurements of social intelligence, which is prepared by the researcher,
having achieved _khasaúsma of psychometric (valid and re
Background: Tooth wear is one of the most common problems in the older dentate population which results from the interaction of three processes (attrition, abrasion and erosion) and it affects all societies, different age groups, and all cultures. This study was achieved to evaluate the prevalence and distribution of tooth wear among institutionalized residents in Baghdad city\ Iraq. Subjects and Methods: This survey was accomplished on four private and one governmental institution in Baghdad city. One-hundred twenty three (61 males, 62 females) aged 50-89 years were participated in this study. The diagnosis and recording of tooth wear were according to criteria of Smith and Knight. Results: The prevalence of tooth wear was 100% with a mean
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