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 surgery Keywords: Non-surgical treatment of anal fissure, fissure in ano, sphicterotomy,botulinum toxin in anal fissures, glyceryl trinitrate. Chemical sphincteratomy, pharmacological sphincteratomy.
The study showed significant differences between the average weight lens and the average amount protein in the lens between that Kestrel Falco tinnunculus L. and the Collared Dove Streptopelia decaocto F. , also the study electrical migration of lens proteins having one bundle of crystalline –? in Kestrel compared with three bundles in Collared Dove, two bundles of crystalline – ? in both , and crystalline – ? appeared as one bundle in both birds.
There is no doubt that each of the arts has a material from which the aesthetic achievement is built, so the researcher found that the art of theater, especially the show, whose artistic achievement is based on the body of the actor who emits the formal language (body language), is the focus of interest and active presence, because the body possesses its spiritual qualities that made him and the ability to The formation of things by (his body language), so the researcher studied this theatrical phenomenon and divided it into four chapters. In the first chapter, the research problem included the following question: (Is there a phenomenon of body language in the contemporary theatrical show "Imagine that" as a model) so It is of cognitive
... Show MoreThe research focuses on determining the role of customer relationship management in improving financial performance by surveying the opinions of a number of employees of a number of Iraqi private banks. The customer has become the focus of attention and the most important factors of success and profitability and competition. Therefore, decisions related to the customer are important decisions that support the process of making, And follow-up of administrative decisions, including financial decisions aimed at improving the financial performance of banks and distinguish them from competitors. Thus, the techniques used in customer relations management programs to collect, analyze and use data and information have beco
... Show MoreBackground: Type 2 diabetes mellitusand chronic periodontitis hold a close relationship that has been the focus of many researches. Currently there is an appreciation to the role of adipose tissue-derived substances "the adipokines" in immune-inflammatory responses; also, there is an interest in using the simple non-invasive saliva in diagnosing and linking oral and general health problems. The current study aims to determine the periodontal health status in the chronic periodontitis patients with and without poorly or well controlled type 2 diabetes mellitus, measure the salivary levels of two adipokines "leptin and resistin", pH and flow rate and then correlate between these clinical periodontal, biochemical and physical parameters in eac
... Show MoreBackground: Many materials were proposed as root canal obturating materials but the biocompatibility issue remains to be a critical one. Propolis has been used as a therapeutic agent since the time of Hippocrates. It is known that propolis exhibits some pharmacological activities, such as antibacterial, antiviral, antifungal and anti inflammatory activity. Materials and methods: Eighteen albino rats were used in the study and divided randomly into three groups of 6 animals for each group. Each group was scheduled to be sacrificed at different time periods, which were three days, one week and three weeks. Propolis and ZOE sealer implants of 4mm in diameter and 0.5 gm in weight were implanted in the dorsal side of the rats. At the end of the
... Show MoreBackground: One of the major problems in endodontics is micro-leakage of root canal fillings which might contribute to the failure of endodontic treatment. To avoid this problem, a variety of sealers have been tested. The objective of this, in vitro, study was to evaluate the shear bond strength of four resin based sealers (AH plus, silver free AH26, RealSeal SE and Perma Evolution permanent root canal filling material) to dentin. Materials and Methods: Forty non-carious extracted lower premolars were used. The 2mm of the occlusal surfaces of teeth were sectioned, to expose the dentin surface. The exposed dentin surfaces of teeth were washed with 5ml of 2.5% NaOCl solution followed by 5ml of 17 % EDTA then rinsed by deionized water to remov
... Show MoreTraining has occupied a leading position in a large number of developed and developing countries alike in order to develop the skills of workers in line with the changes and developments of the era, including monitoring compliance in banks, which is one of the most important jobs in banking work to trailing and monitor the bank’s compliance with laws, regulations and instructions in order to achieve its goals Therefore, the problem of this research focuses on the following question: What is the role of training in enhancing banking compliance at the present time? In order to clarify the relationship between the main and sub-research variables, two main hypotheses and three sub-hypotheses were formulated for each hypothesis, and t
... Show MoreThe current study aimed at (identifying the impact of a proposed strategy based on the realistic mathematics theory in the mathematical interrelation among the third intermediate grade students), two samples from the third intermediate grade were tested in a school affiliated to Rusafa I General education Directorate in Baghdad for the academic year (2022-2021)the experimental group will study according to the proposed strategy and it consisted of (30) female students , the control group will study through the traditional method and the number of its students is (30), thus the study sample consisted of (60) female students, the two groups were equalized in the variables (age in months, intelligence, prior knowledge) and to achieve the study
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