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.
Pricing has an important position among the elements of marketing mixture (4ps) as it represents revenues that in turn represent one of the important pillars' for resources affecting on organizations sustainability and development , and the failure in determining prices and their strategies has a dangerous effect on the organizations reality and future as a whole . from this point, this is what from the focus of the research problem,which centered on how to get companies to critical price that satisfies customers and achieve corporate objectives.
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Nonmissile penetrating spine injury (NMPSI) represents a small percent of spinal cord injuries (SCIs), estimated at 0.8% in Western countries. Regarding the causes, an NMPSI injury caused by a screwdriver is rare. This study reports a case of a retained double-headed screwdriver in a 37-year-old man who sustained a stab injury to the back of the neck, leaving the patient with a C4 Brown-Sequard syndrome (BSS). We discuss the intricacies of the surgical management of such cases with a literature review.
PubMed database was searched by the following combined formula of medical subjects headings,
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In this work chemical vapor deposition method (CVD) for the production of carbon nanotubes (CNTs) have been improved by the addition of S. Steel mesh container (SSMC) inside which the catalyst (Fe/Al2O3) was placed. Scanning electron microscopy (SEM) investigation method used to study nanotubes produced, showed that high yield of two types of (CNTs) obtained, single wall carbon nanotube (SWCNTs) with diameter and length of less than 50nm and several micrometers respectively and nanocoil tubes with a diameter and length of less than 100nm and several micrometers respectively. The chemical analysis of (CNTs) reveals that the main component is carbon (94%) and a little amount of Al (0.32%), Fe (2.22%) the reminder is oxygen. It was also fou
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Ketoprofen has recently been proven to offer therapeutic potential in preventing cancers such as colorectal and lung tumors, as well as in treating neurological illnesses. The goal of this review is to show the methods that have been used for determining ketoprofen in pharmaceutical formulations. Precision product quality control is crucial to confirm the composition of the drugs in pharmaceutical use. Several analytical techniques, including chromatographic and spectroscopic methods, have been used for determining ketoprofen in different sample forms such as a tablet, capsule, ampoule, gel, and human plasma. The limit of detection of ketoprofen was 0.1 ng/ ml using liquid chromatography with tandem mass spectrometry, while it was 0
... Show MoreDylan Thomas (1914-1953) is a modern poet belongs to the apocalyptic movement of the 1940's.This movement is influenced by the doctrines and techniques of surrealism.
Poetry for him should not be primarily concerned with man in society, but with the celebration of spiritual truth. It should bring to light the hidden causes, hence his personal interest is to strip darkness and explore the inward motives. To do this he uses a cluster of images: a constant building up and breaking down of images. His poetry depends on the romantic spontaneity, suggestiveness of the Symbolists and the the surrealists' mysterious liberation of the unconsciousness and
... Show MoreTelevision culture has become the most dangerous of our time. It manipulates with minds and hearts together; and forms consciousness. It transforms societies into actual forces rejecting certain principles by guiding the media landscape through visible connotations acceptable to the public; or provokes the citizen against elements that put a burden on the viewer or the public in order to create a positive reaction to the subject of combating terrorism by combining these ads in line with what the public wants of security and tranquility and a decent living after suffering from terrorism in the past years.
Therefore, this research deals with television advertisements as one of the most important fo
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The goal of the research is to develop a sustainable rating system for roadway projects in Iraq for all of the life cycle stages of the projects which are (planning, design, construction and operation and maintenance). This paper investigates the criteria and its weightings of the suggested roadway rating system depending on sustainable planning activities. The methodology started in suggesting a group of sustainable criteria for planning stage and then suggesting weights from (1-5) points for each one of it. After that data were collected by using a closed questionnaire directed to the roadway experts group in order to verify the criteria weightings based on the relative importance of the roadway related impacts
... Show MoreElectrical distribution system loads are permanently not fixed and alter in value and nature with time. Therefore, accurate consumer load data and models are required for performing system planning, system operation, and analysis studies. Moreover, realistic consumer load data are vital for load management, services, and billing purposes. In this work, a realistic aggregate electric load model is developed and proposed for a sample operative substation in Baghdad distribution network. The model involves aggregation of hundreds of thousands of individual components devices such as motors, appliances, and lighting fixtures. Sana’a substation in Al-kadhimiya area supplies mainly residential grade loads. Measurement-based
... Show MoreDylan Thomas (1914-1953) is a modern poet belongs to the apocalyptic movement of the 1940's.This movement is influenced by the doctrines and techniques of surrealism. Poetry for him should not be primarily concerned with man in society, but with the celebration of spiritual truth. It should bring to light the hidden causes, hence his personal interest is to strip darkness and explore the inward motives. To do this he uses a cluster of images: a constant building up and breaking down of images. His poetry depends on the romantic spontaneity, suggestiveness of the Symbolists and the the surrealists' mysterious liberation of the unconsciousness and the emotional involvement in the dynamics of life. In "Light Breaks
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