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.
The research explores the confessional aspect in Audre Lorde's poem" Who Said It Was Simple ". Lorde depicts her personality under the stress of race, sex and sexuality. She discloses her own bitter experience concerning racism, sexism and sexuality in her poem to revive the retrospective truth of the Afro-Americans' life in the USA. This publicly manifestation of her personality and tribulation throughthe language ofpoetry has been regarded as the hallmark of confessional poetry.
Toni Morrison (1931-), the first African-American winner of Noble Prize in literature (1993) and the winner of the 1988 Pulitzer Prize for fiction, regards herself as the historian of African-American people. She does not think of her writings as literature but as a sacred book dedicated to explore the interior lives of blacks. She creates history by disregarding European standards and the white man's view of African- Americans. She adopts her people's point of view, invests their heritage, voices their pains and uses their vernacular. She even writes to a black audience. She establishes the black novel by depicting the blackness of American literature. In choos
... Show MoreBackground: The marginal seal is essential for sealant success because penetration of bacteria under the sealant might allow caries onset or progression. The aim of the present study was to estimate and compare the microleakage of pit and fissure sealant after various methods of occlusal surface preparation. Materials and methods: Thirty non-carious premolars extracted for orthodontic reasons were equally divided into three groups. In group one, occlusal fissures were opened with round carbide bur, in group two, occlusal surfaces of the teeth were cleaned with a dry pointed bristle brush and samples of group three were cleaned with a slurry of fine flour of pumice in water using rubber cup. Then fissures of all teeth were etched using 35% p
... Show MoreStealth marketing is considered as one of the contemporary issues that researchers have begun to explore as a current understanding. It is the marketing approach used by organizations to promote their products and services to the public in implicit and indirect manner. In this article, the concept of stealth marketing will be discussed throw its advantages and disadvantages. In addition, the different techniques of stealth marketing have been discussed including: viral marketing, celebrity marketing, brand pushers, bait-and-tease marketing, video games marketing, and marketing in music. Furthermore, a new technique of marketing entitled “Marketing through social responsibility” has been added and discussed according to the themes in the
... Show MoreThyroid hormones (TH) regulate the metabolic processes required for normal development and growth; also, to organizemetabolism in adults, any defect in thyroid function leads to abnormality in thyroid hormones level. The current study hasbeen designed to find the relationship between retinol-binding protein-4 and progranulin in the serum of Iraqi women withhypothyroidism and hyperthyroidism, also, to study whether these patients are exposed to a risk of developing diabetes mellitus,and PGRN may be a biomarker in detection early stage of diabetes mellitus.Materials and Methods: in this study, serum samples were obtained from 50 Iraqis women patients, [25 patients withhypothyroidism (G2) and 25 patients with hyperthyroidism (G3)] in addition
... Show MoreIn this paper, a new form of 2D-plane curves is produced and graphically studied. The name of my daughter "Noor" has been given to this curve; therefore, Noor term describes this curve whenever it is used in this paper. This curve is a form of these opened curves as it extends in the infinity along both sides from the origin point. The curve is designed by a circle/ ellipse which are drawing curvatures that tangent at the origin point, where its circumference is passed through the (0,2a). By sharing two vertical lined points of both the circle diameter and the major axis of the ellipse, the parametric equation is derived. In this paper, a set of various cases of Noor curve are graphically studied by two curvature cases;
... Show MoreMany cities suffer from the large spread of slums, especially the cities of the Middle East. The purpose of the paper is to study the reality of informal housing in Al-Barrakia and the most important problems that it suffers from. The paper also seeks to study the presence or absence of a correlation between urban safety indicators and urban containment indicators as one of the methods of developing and planning cities. This can be achieved through sustainable urban management. The slums are a source of many urban problems that threaten the security and safety of the residents and represent a focus for the concentration of crimes and drugs. The paper seeks to answer the following question: How can urban safety be improved through urban cont
... Show MoreThis review is concluded of 8-Hydroxyquinline (8HQ) compound and derivatives which has a very significant interests with a strong fluorescence , furthermore the relationship between divalent metal ions and characteristic of chelating . In the same way coordinated features have increase of its organic action and inorganic behavior by giving many samples of compounds which are a good chelating agents ligands with more capable of forming very stable complexes.Therefore, the role of (8HQ) is not limited on complexes only but its applications in different fields so this review will focus on demonstration preparation methods and properties of (8HQ) derivatives with their complexes and applications, hopefully that we will cover a part of scientifi
... Show MoreThe formula is effective in Surat Nisa
(A study of gramophone)
in the name of o Allah the Merciful
Praise be to Allah, Lord of the Worlds, and prayers and peace be upon the Seal of the Prophets and Messengers. The envoy is a mercy to the worlds Muhammad Sadiq Al - Amin and to the pure and good companions of the Tayyibites.
The formula of the morphological formulas, which have diverged from other meanings, whether lexicon or contextual and what this formula contains many meanings (effective source) and (effective in the sense of effective) and (effective sense reactor) and (effective sense) and ( (F) in the sense of a similar character) and ((the name of the) (collect). This was dealt with in the formula in Surat al-Nisaa