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.
This study examines strategies of cultural domestication in Muravyov and Kistyakovsky’s Russian translation of (The Fellowship of the Ring). It documents transformations of character names, toponyms, dialogues, and cultural references, highlighting systematic Russification and the infusion of Soviet political commentary that reshape the text into cultural rewriting.
In light of the developments and intense competition that the world has witnessed, the need to search for a sustainable and continuous competitive advantage for economic units has emerged, as the economic units must not lose sight of their interest in the activities they perform to achieve that advantage, and it can be said that the goal of the research is to identify the theoretical dimensions of the green value chain represented by: (Green research and development, green design, green manufacturing, green marketing, green services) and the dimensions of the sustainable competitive advantage represented by (quality, creativity, innovation, cost, response to the customer), as well as identifyi
... Show MoreBackground: Malignant lymphoma is the generic term given to tumors of the lymphoid system and specifically of lymphocytes and their precursor cells, While all lymphomas are malignant neoplasms, there is a wide spectrum of clinical behavior, with some following an indolent clinical course and others behaving in an aggressive manner (will causing death in a short time frame if left untreated). The metastatic process involves intravasation and extravasation of tumor cells, followed by reimplantation of tumor cells, formation of a new tumor stoma, Degradation of the extracellular matrix and components of the basement membrane by proteases facilitates the detachment of tumor cells, their crossing of tissue boundaries, and invasion into adjacent
... Show MoreBackground: Oral health represents an important base for human well-being; the heath of the body begins from oral cavity. Great deal has been applied to increase knowledge in the field of oral health in order to develop appropriate preventive program. This study was conducted in order to estimate the percentage and severity of dental caries and gingivitis among children attending Preventive Department in Collage of Dentistry, University of Baghdad and to determine dental treatment need for those patients, further more to study the relation of these variables with dental knowledge. Materials and Methods: The study group consists of 163 children with an age ranged from 6 to 14 years, who attended the preventive clinic for the first time to be
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The Central Bank is the backbone of the banking system as a whole, and in order to maintain the banking system, one of the most important functions that the Central Bank performs is the function of supervising and controlling banks, with several tools and methods, and one of the most important of these tools is its creation of the function of a compliance observer, which obligated commercial banks to appoint a person in A bank that performs this function according to certain conditions and granting it some powers that would build a sound and compliant banking system. The function of the compliance observer is to follow up on the bank’s compliance with the instructions and decisions issued by
... Show MoreThe adsorption ability of Iraqi initiated calcined granulated montmorillonite to adsorb of 4-(4-Nitrobenzeneazo) 3-Aminobenzoic Acid from aqueous solutions has been investigated through columnar method. The azo dye adsorption found to be dependent on adsorbent dosage, initial concentration and contact time. All columnar experiments were carried out at three different pH values (5.5, 7and 8) using buffer solutions at flow rate of (3 drops/ min.), at room temperature (25±2) °C. The experimental isotherm data were analyzed using Langmuir, Freundlich and Temkin equations. The monolayer adsorption capacity is 6.4066 mg Azo ligand per 1g calcined Montmorillonite. The experiments showed that highest removal rate 90.5 % for azo dye at pH 5.5.The
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The current research aims to develop a guidance program suitable for high school students and apply it to them in order to ensure the reduction of addiction to the use of different means of communication. The researchers used the scale of addiction to the means of communication (SAS) to measure the level of addiction as well as to identify the impact of the proposed guidance program in reducing the degree of addiction to communication. It was applied to a sample of (20) female students divided equally into two groups: an experimental group of (10) female students and a control group of (10) female students from the secondary level in a school under the department of education in the education of the alma
... Show MoreLimitations of the conventional diagnostic techniques urged researchers to seek novel methods to predict, diagnose, and monitor periodontal disease. Use of the biomarkers available in oral fluids could be a revolutionary surrogate for the manual probing/diagnostic radiograph. Several salivary biomarkers have the potential to accurately discriminate periodontal health and disease. This study aimed to determine the diagnostic sensitivity and specificity of salivary interleukin (IL)‐17, receptor activator of nuclear factor‐κB ligand (RANKL), osteoprotegerin (OPG), RANKL/OPG for differentiating (1) periodontal health from disease and (2) stable a
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Background: Multiple sclerosis is a chronic autoimmune inflammatory demyelinating disease of the central nervous system of unknown etiology. Different techniques and magnetic resonance image sequences are widely used and compared to each other to improve the detection of multiple sclerosis lesions in the spinal cord. Objective: To evaluate the ability of MRI short tau inversion recovery sequences in improvementof multiple sclerosis spinal cord lesion detection when compared to T2 weighted image sequences. Type of the study: A retrospective study. Methods: this study conducted from 15thAugust 2013 to 30thJune 2014 at Baghdad teaching hospital. 22 clinically definite MS patients with clinical features suggestive of spinal cord involvement,
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