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.
To the Banks capital several uses, including the protection of deposits and this was approved by the Basel Committee, And Finance long-term investments which intended to investment in fixed assets that are essential to the continuation of banking activity, Fixed assets not financed from the funds of the deposit, but the owner equity do this jop. the current research tries to prove the effect of banks capital on fixed assets for a sample of iraqi private banks (bank of baghdad and Iraqi middle east Investment bank), for the period from 2011 until 2014. The research concluded that the capital of bank of baghdad affect on his total fixed assets by (84%), and the capital of Iraqi middle east Investment bank affect on his total fixed assets b
... Show MoreThe research aims to identify the factors affecting the customer and their impact desire for market share in a competitive market National Insurance Company, where he was after the tremendous developments that have taken place in the insurance sector, crowded markets, private companies and the intensified competition among those companies on one side and public sector companies, including national insurance company on the other hand, increased attention and study in a big way the customer and the factors influencing the desire. As the national insurance company ascertains its targets once the sale of insurance documents only, but by knowing the tendencies and aspirations of current and prospective customers a way that helps to strengthen
... Show MoreThis paper presents a three-dimensional Dynamic analysis of a rockfill dam with different foundation depths by considering the dam connection with both the reservoir bed and water. ANSYS was used to develop the three-dimensional Finite Element (FE) model of the rockfill dam. The essential objective of this study is the discussion of the effects of different foundation depths on the Dynamic behaviour of an embanked dam. Four foundation depths were investigated. They are the dam without foundation (fixed base), and three different depths of the foundation. Taking into consideration the changing of upstream water level, the empty, minimum, and maximum water levels, the results of the three-dimensional F
Background: Despite the fact that asthma is a long-term disease that may be treated, many people are unable to control their symptoms due to a lack of knowledge about their condition. The study's purpose was to find out if a pharmacist intervention improved asthma management because of this.
Objective: this study designed to assess the effect of pharmaceutical care on pulmonary functions test.
Method: The study was completed in three months. The patients who were enrolled were divided into two groups: Group 1 consists of 23 asthma patients who were randomly assigned to receive conventional therapy for chronic bronchial asthma based on disease stage and se
... Show MoreIn this work a series of fourteen new compounds were synthesized. Compound [1] was formed from the reaction of 2-aminobenzothiazole and p-bromophenacyl bromide. Aldehyde group [2] was obtained from the reaction of compound [1] with pocl3 in presence of DMF and CHCl3 .After that shiff bases have been synthesized from the reaction of compound [2] with different aromatic amine to give new shiff bases [3- 5]. These new shiff bases have been reduced to their corresponding amine [6-8] by means of sodium borohydride. Then reaction of shiff bases [3-5] with phenyl isocyanate gives 3-cyclic lactam derivatives [9-11]. 3-cyclic Oxazepine derivatives [12-14] were obtained by reaction of shiff bases [3-5] with succinic anhydride. These new formed co
... Show MoreThis study deals with segmenting the industrial market as an independent variable and targeting the industrial market as a dependent variable. Since the industrial sector represents one of the most important fundamental pillars to build the economies of countries and their development , the Iraqi industrial sector was chosen as a population for the study . Based on measuring the study variables , identifying them and testing the correlation and effect on each other , the study reached a group of findings:
1- Increasing the level of availability of study variables inside the companies “The study sample”.
2- There is a correlation between the independent v
... Show MoreThe objective of this study is to ascertain the pivotal role of headlines in captivating viewers' attention toward news bulletins. Additionally, it aims to explore the factors that contribute to the correlation between headlines and the public's acceptance or rejection of the meticulously crafted news articles presented through these bulletins. The study delves into the mechanisms employed in writing and editing headlines, focusing on their style, expert composition, and intriguing nature. These factors inevitably influence the level of acceptance and engagement of the viewership with the news articles disseminated via the news bulletins. Employing a descriptive methodology, the researcher distributed 200 question
... Show MoreBackground: The purpose of this study is to compare the color changes between the bonded middle third and the unbonded gingival and incisal thirds, fallowing fixed orthodontic treatment Material and method: The color parameter l, a, b has been recorded for each thirds in upper anterior teeth by mean of easy shad device. The has been calculated for gingival, middle and incisal thirds for the upper anterior teeth in 34 patient, 17 males and 17femals, those subject undergone fixed orthodontic treatment Results: The in middle bonded third is highly significant higher than that in incise and gingival thirds p<0.01 because the middle third isn’t expose to oral fluid and dental brushing since it covered by the bracket. Also there
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