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.
Almost all thermal systems utilize some type of heat exchanger. In a lot of cases, evaporators are important for systems like organic Rankine cycle systems. Evaporators give a share in a large portion of the capital cost, and their cost is significantly attached to their size or transfer area. Open-cell metal foams with high porosity are taken into consideration to enhance thermal performance without increase the size of heat exchangers. Numerous researchers have tried to find a representation of the temperature distribution closer to reality due to the different properties between the liquid and solid phases. Evaporation heat transfer in an annular pipe of double pipe heat exchanger (DPHEX) filled with cooper foam is investigated numerical
... Show MoreThere are significant differences between the pre and post-tests in favor of the post-test in the tests) stroke volume (S.V), cardiac thrust (C.O.P), left ventricular volume, maximum oxygen consumption Vo2max), which indicates the effect of the proposed training approach.There are significant differences between the pre and post-tests in favor of the post-test in the achievement level test with air rifle shooting for young female shooters, which indicates the effect of the proposed training curriculum.There are no significant differences between the pre and post-tests in the tests (heart rate (HR) before exercise, heart rate (HR) after exercise, systolic blood pressure rate before exercise, systolic blood pressure rate after exercis
... Show MoreThe websites over time have become one of the important tools for communication between individuals among themselves and between individuals and economic units, and they have emerged as one of the important intangible assets to achieve income, as they have become a competitive tool and a marketing outlet for these units and a main means of communication that it uses to exercise its various major activities and achieve potential economic benefits. Therefore, there was a need to measure and display the value of these sites in the financial statements as intangible assets. Accordingly, the purpose of the research was to determine the costs of the websites owned by the economic unit by way purchase and sites that were created i
... Show MorePublic budget is the government's tool in achieving the objectives of economic and social development is the accounting curriculum to estimate state revenues and expenditures for years to come, as well as to have legal status as it is after the adoption of an official statement of government units to spend funds on items planned at the same time is a statement collect resources to finance these appropriations, if the primary objective of the budget initially limited to the achievement of financial and legislative control have evolved this function in the area of public administration turned attention from mere imposition of control over the money, which provides information to assist the Department to utilize available resources and prog
... Show MoreBackground: This study aimed to examine the efficacy of methylene blue (MB) and toluidine blue O (TBO) photodynamic therapy (PDT) as adjuncts to root surface debridement (RSD). Methods: This split-mouth, randomized, controlled clinical trial included eighteen patients, and a total of 332 sites (control = 102, MB = 124 and TBO = 106) were examined. Two sessions of PDT were completed at baseline and two weeks after RSD. Clinical parameters of bleeding on probing (BOP), plaque index (PI), probing pocket depth (PPD), and clinical attachment level (CAL) were measured pre- and post-treatment. Results: PPD and BOP reductions in sites treated by RSD with adjunctive photosensitizers (MB and TBO) were significantly higher than in control site
... Show MoreObjective(s): In the present study, glycerin is used as a substitute for tin-foil and cold mold seal (Alginate mould seal)
in the process of curing heat and cold-cure acrylic resin denture base against stone and plaster.
Methodology: 60 specimens were prepared from heat-cure acrylic resin and cold-cure acrylic resin denture base. The
study includes 12 groups of specimens depending on the type of processing, investment material and type of
separating medium that are used in curing process. Each group of them contains 5 specimens for each test.
Some of physical properties of the processed acrylic denture base that (water sorption and solubility) have been
compared with those processed using tin-foil and tin-foil substitut
The research aimed at measuring the compatibility of Big date with the organizational Ambidexterity dimensions of the Asia cell Mobile telecommunications company in Iraq in order to determine the possibility of adoption of Big data Triple as a approach to achieve organizational Ambidexterity.
The study adopted the descriptive analytical approach to collect and analyze the data collected by the questionnaire tool developed on the Likert scale After a comprehensive review of the literature related to the two basic study dimensions, the data has been subjected to many statistical treatments in accordance with res
... Show MoreBackground: Measuring implant stability is an important issue in predicting treatment success. Dental implant stability is usually measured through resonance frequency analysis (RFA). Osstell® RFA devices can be used with transducers (Smartpeg™) that correspond to the implants used as well as with transducers designed for application with Penguin® RFA devices (Multipeg™). Aims: This study aims to assess the reliability of a MultiPeg™ transducer with an Osstell® device in measuring dental implant stability. Materials and Methods: Sixteen healthy participants who required dental implant treatment were enrolled in this study. Implant stability was measured by using an Osstell® device with two transducers, namely, Smartpeg™ and M
... Show MoreDiscretionary Punishment, Public Regulation, Interest