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.
This research means a study (the impact of the Arab-Islamic environment on contemporary painting, the artist Abd al-Rahman al-Suleiman as a model). The research falls into two axes: the first: the theoretical axis, and the second: the applied axis. The first axis dealt with an introduction that contained: (the research problem, its importance, its goal, its limits, and the definition of terms). This research aims to uncover (the impact of the Arab-Islamic environment on contemporary painting, and the artist Suleiman was a model). And the research limits spatially: Saudi Arabia, and temporally: 2010-2014. This theme included two topics: The first: the characteristics of the Saudi environment and its impact on art. The second: the s
... Show MoreBackground: The purposes of this study were to determine the photogrammetric soft tissue facial profile measurements for Iraqi adults sample with class II div.1 and class III malocclusion using standardized photographic techniques and to verify the existence of possible gender differences. Materials & methods: Seventy five Iraqi adult subjects, 50 class II div.1 malocclusion (24 males and 26 females), 25 class III malocclusion (14 males and 11 females), with an age range from 18-25 years. Each individual was subjected to clinical examination and digital standardized right side photographic records were taken in the natural head position. The photographs were analyzed using AutoCAD program 2007 to measure the distances and angles used in t
... Show MoreThis study investigates the requirements of total quality management (TQM) and the determinants affecting its application in Al-Zaman newspaper, one of Iraq’s leading private press institutions. The research employed a survey methodology, using a structured questionnaire administered to 30 participants representing journalistic, administrative, and technical staff. Five TQM dimensions, each measured through four indicators, were assessed to capture the perceptions of employees regarding the availability and effectiveness of quality practices. Data were analyzed using the Statistical Package for the Social Sciences (SPSS). The results revealed that while senior management at Al-Zaman demonstrates formal support for TQM, there is a
... Show MoreThe aim of the research is to measure the relationship and effect of the application of total production maintenance TPM in the operational strategy, as it is considered one of the most important strategies for the process of restoring production losses because of inefficient equipment. Competitive edge in the global market by upgrading the operational strategies of OS in the application of TPM in those institutions that apply both H-OS-oriented and P-OS-oriented strategies where the strategy has been identified as a critical success factor. The aim of this study is to attempt to consider the application of comprehensive productive maintenance in industrial establishments
Background: The aim of this study is to evaluate the color change ∆E of the dental enamel following treatment with 2 kinds of protector (icon infiltrant, clinpro varnish) before fixed orthodontic treatment to avoid the possible white spot lesions. Materials and Methods: Fifty four subjects treated with fixed appliances were divided into 3 groups: the 1st group was control, while the 2nd and 3rd groups were treated with icon infiltrant and clinpro varnish before bonding procedure, respectively. Color parameters (L,a,b) were recorded for the middle and gingival thirds before and after bonding procedure to get the ∆E of each group. Results: One-way ANOVA test showed a non-significant difference in ∆E between the 3 groups a
... Show MoreThis research is a modest effort to talk about the great world of ancient lineage, Imam Majd al-Din Abu Saadat, known as Ibn al-Atheer island, through the statement of his name, surname, nickname, family, elders and his pupils and his most important works.
It also deals with the modern research on his famous book in the field of modern science called (the end in the strange talk and impact), which is one of the most wonderful books of modern and especially the strange talk, through the scientific effort of the Imam and the importance of the book and methodology, and the most prominent aspects of the service and care of Ibn Al Atheer For the modern stranger, which boils down to two aspects:
First: the linguistic rooting of the stran