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.
Extreme conditions will cause the water level of high fill canal segment to change suddenly, which will affect the velocity and pore pressure of the slope. A 9 km irrigation earth canal in the city of Alsyahy, 15 km away from Al-Hilla city, and branching off from the left side of Shatt Al-Hilla at 57 km, was studied. The aim of this work is to study and analyze the effect of rationing system on the Birmana earthen canal during rapid drawdown case. Finite element modeling with Geo-Studio software was used in the present study to analyze the combined seepage and slope stability for three cycles. The resulting minimum safety factor obtained from the analysis using the saturated and
The aim of the study was to evaluate the efficacy of diode laser (λ=940 nm) in the management of gingival hyperpigmentation compared to the conventional bur method. Materials and methods: Eighteen patients with gingival hyperpigmentation were selected for the study with an age between 12-37 years old. The site of treatment was the upper gingiva using diode laser for the right half and the conventional method for the left half. All patients were re-evaluated after the following intervals: 3 days, 7 days, 1 month and 6 months post-operation. Pain and functions were re-evaluated in each visit for a period of 1 day, 3 days and 1 week post-operation. Laser parameters included 1.5 W in continuous mode with an initiated tip (400 μm) placed in
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The research aims to examine the relationship between psychological flow, psychological well-being, and self-management among a sample of fine artists in the Makkah region and its governorates. The research also aims to examine the mean group differences in psychological flow, psychological well-being, and self-management due to demographic variables (sex and years of practicing arts). The sample consists of (110) male and female fine artists. The descriptive correlational approach was performed to collect the data by using the psychological flow scale developed by Payne et al (2011), which was translated by the researcher, the Oxford happiness questionnaire developed by Hills and Argyle (2002), it has t
... Show MoreMarketing Intelligence is one of the important methods of collecting information about competitors ' products and changes in customers ' tastes and needs that contribute to determining the policies to be followed in product development.
The problem of research, which seeks to be answered by the extent to which the companies in question have the appropriate and effective mechanisms to develop their products, and the nature of the relationship between the components of marketing intelligence and new product development policies. The importance of research is determined by the importance of obtaining important and necessary information to make the appropriate decision on the development of the new product an
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Arzı Kanber/Kamber hikayesi Anadolu, Rumeli, Azerbaycan, Türkmenistan ve Irak gibi Türk dünyasının birçok yerinde birden fazla varyantı bulunan, çok sevilen ve yaygın olarak anlatılan aşk ve dramatik maceralı bir halk hikayesidir. Türk halk hikayelerinin en popüler olanlarından biri sayılan Arzı Kanber/Kamber hikayesi, Anadolu'nun birçok yöresinde bilinmesine rağmen Irak Türkmenleri arasında daha çok sevildiği ve yaygın olarak anlatıldığı tespit edilen birden fazla varyantından da görülebilir. Irak Türkmenleri arasında günümüze kadar hikayenin iki varyantı tespit edilmi
... Show MoreThe aim of the research is to measure the change in the impact of the factors of the Corona pandemic on psychological sensitivity and COVID-19 phobia in a sample of Bisha University students and to detect the differences in the phobia (phobia) Covid-19 among the sample members in the measurement before the ban and after the ban was opened, in addition to the differences in psychological sensitivity of The sample has between sizes before and after the spread of the Corona pandemic, as well as the differences in them according to the gender variable (male, female). The researcher relied on the comparative approach. The scale of psychological sensitivity and COVID-19 phobia was applied to a sample of (62) male and female respondents.
... Show MorePhase change material (PCM) is considered as one of the most effective thermal energy storage (TES) systems to balance energy supply and demand. A key challenge in designing efficient PCM-based TES systems lies in the enhancement of heat transmission during phase transition. This study numerically examines the privilege of employing twisted-fin arrays inside a shell-and-tube latent heat storage unit to improve the solidification performance. The presence of twisted fins contributes to the dominating role of heat conduction by their curved shapes, which restricts the role of natural convection but largely aids the overall heat-transfer process during solidification. The heat-discharge
To investigate the antiplaque and antigingivitis efficacy in addition to evaluating side effects and subjects’ perceptions of three commercially available mouthwashes.
This study was a double‐blind, parallel, and short‐term trial. A total of 75 dental students with biofilm‐induced gingivitis were included in the final analysis of the current study. Clinical parameters (plaque index and bleeding on probing) and the staining effect were measured at baseline and after 7 days. In addition, a VAS‐based assessment questionnaire was completed by the participants.