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.
Researchers are interested in the issue of children abuse and they look for its cause in the past and present. Their interest is limited to identifying penal liability which is caused by children abuse away from focusing on civil liability. So, the study is going to clarify the parents' responsibility for children abuse rather than civil liability of the medic in case he wouldn’t notify the authorities about the case according to the American law rules and the attitude of Iraqi law rather than some judicial application of civil cases that were exposed to American judiciary concerning children abuse.
Racism changes its meaning, shape, purpose or function according to various factors such as time, place, motives, and backgrounds; among others. It seems, however, to have deep roots back in the history of mankind. Such a concept stems from a perceived difference with the other. It is fed by the feeling of being hierarchically superior in opposition to another party that is depicted as inferior. Since ancient times, racism is disguised in different forms and manifests itself on various levels. It is a truism that this ideology can be best presented via language.
Due to its negative implication, racism lends itself to a critical kind of research. As such, this paper is a critical pragmatic investigation for this phenomenon a
... Show MoreThe dyes Azo have a lengthy history and are a vital part of our daily lives. There are numerous potentials uses for these substances and their derivatives in various industries and environmental and biological research. In this study conversion of various azo compounds into other derivatives, complexes, and polymers was accomplished. This review included examining the chemistry reactions, synthesis, and applications of azo dye ligands and their complexes, mentioned spectral, analytical, thermal, and morphology methods of investigation, and confirmed by mass fragment mechanisms for some azo dyes and metal complexes. One of the aims of this review is to explain the role of these azo dye derivatives and the effect of metal complexes on leather
... Show MoreIn this review of literature, the light will be concentrated on the local drugs delivery systems for treating the periodontal diseases. Principles, types, advantages and indications of each type will be discussed in this paper.
The novel has recently received great attention from readers and before them writers, due to the role it is playing, and this indicates an important rule, which is whenever there is art or creativity, there must be a criticism of its own, and this criticism is certainly no less important than its owner, so we find There are critics who have their distinguished literary position in following up the narrative development, and trying to describe the transformation of its elements, including Professor Fadel Thamer, and whoever wants to approach an element of the novel as an explorer, he must stand on the visions of this critic about it, and this is what made us take the element (personality) Tracking the most important opinions of the critic
... Show MoreSolvents are important components in the pharmaceutical and chemical industries, and they are increasingly being used in catalytic reactions. Solvents have a significant influence on the kinetics and thermodynamics of reactions, and they can significantly change product selectivity. Solvents can influence product selectivity, conversion rates, and reaction rates. However, solvents have received a lot of attention in the field of green chemistry. This is due to the large amount of solvent that is frequently used in a process or formulation, particularly during the purification steps. However, neither the solvent nor the active ingredient in a formulation is directly responsible for the reaction product's composition. Because these ch
... Show MoreThe determination of aerodynamic coefficients by shell designers is a critical step in the development of any projectile design. Of particular interest is the determination of the aerodynamic coefficients at transonic speeds. It is in this speed regime that the critical aerodynamic behavior occurs and a rapid change in the aerodynamic coefficients is observed. Two-dimensional, transonic, flow field computations over projectiles have been made using Euler equations which were used for solution with no special treatment required. In this work a solution algorithm is based on finite difference MacCormack’s technique for solving mixed subsonic-supersonic flow problem. Details of the asymmetrically located shock waves on the projectiles hav
... Show MoreProfessional learning societies (PLS) are a systematic method for improving teaching and learning performance through designing and building professional learning societies. This leads to overcoming a culture of isolation and fragmenting the work of educational supervisors. Many studies show that constructing and developing strong professional learning societies - focused on improving education, curriculum and evaluation will lead to increased cooperation and participation of educational supervisors and teachers, as well as increases the application of effective educational practices in the classroom.
The roles of the educational supervisor to ensure the best and optimal implementation and activation of professional learning soci
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