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 marketing of banking service is considered to be one of the impotent fields which showed a universal inebriates . He research showed the comparison between the application of marketing in ideas and application for loot government and private Iraqi bank. The research comets of four parts; Mythology / the concept and the importance of Banking Marketing / Research applichlion/ Conelnion and recommendation.
Background: periodontitis is a chronic inflammatory disease causing destruction of the tooth supporting structures, initiated by dental plaque and modified by environmental and genetic risk factors. Cyclooxygenase-2 (COX-2) enzyme is responsible for the production of prostaglandin E2, an important mediator in the chronic periodontitis (CP) pathogenesis. Polymorphisms in COX-2 gene have linked to CP in different populations. Aim: To study the association between Cyclooxygenase-2 single nucleotide polymorphism rs689466 (-1195A/G SNP) and chronic periodontitis in a sample of Iraqi population. Methods: One hundred Iraqi subjects divided into two groups: case group consisted of 70 CP patient (35 males and 35 females) with age range 30-55 year
... Show MoreThe health care industry is witnessing an increasing trend in the use of generic medicines because of their presumed low cost compared with innovator medicines. The aim of this study was to determine and compare the performance of the copy drug Osveral®and its innovator drug deferasirox (Exjade®).
A prospective observational study including 223 patients receiving the branded medicine Exjade®and 101 patients receiving the copy Osveral®was carried out. Data were assessed for a 1-year period and included clinical symptoms, serum ferrit
The research aims to identify the role of strategic improvisation as an independent variable with its dimensions (Building the Solution, Intuition, Adaptation, and Spontaneity) and the Entrepreneurial Orientation as a dependent variable with its dimensions (Identifying Opportunities, Creativity, Adopting risk, and Vision). This research has been applied in the Rafidain Bank and its branches (Sunk, People, Al-Firdaws, and Alawiya); it used the questionnaire as a basic tool for collecting information. The sample was intentionality, which included all the heads of departments in the bank’s branches, which amounted to (33) workers, and data on the questionnaire paragraphs of 28 were processed using the SPSS V.23 and AMOS V.23). The most impor
... Show MoreIn a world of limited space, the owners are always surrounded by others next to them, and, consequently, there is hardly any activity which the owner may exercise on his land which would not affect the other owners. If he builds a building, that building may block the sun's rays or the air from the buildings next to it and owned by other people. And if he runs a business, the lands adjacent to that business may be overburdened with the accompanying noise or traffic. If oil is prospected in a land, the neighboring lands may be deprived of oil or their owners may be exposed to toxic fumes. Hence the importance of researching the intention of harming others, as it is one of the most important forms of abuse in the use of the right (especially
... Show MoreCatalytic wet air oxidation of aqueous phenol solution was studied in a pilot plant trickle bed reactor using copper
oxide catalyst supported on alumina and silica. Catalysts were prepared by impregnating method. Effect of feed solution
pH (5.9, 7.3, and 9.2), gas flow rate (20%, 50%, 80%, and 100%), WHSV (1, 2, and 3 h-1), temperature (120°C, 140°C,
and 160°C), oxygen partial pressure (6, 9, 12 bar), and initial phenol concentration (1, 2, and 4 g/l).Generally, the
performance of the catalysts was better when the pH of feed solution was increased. The catalysts deactivation is related
to the dissolution of the metal oxides from the catalyst surface due to the acidic conditions. Phenol oxidation reaction
was strongly
The influence of 5-10 kHz audio frequency on the power dissipation in ac discharge of argon gas was studied experimentally, at pressures 50-80 mTorr and electrodes separation 10 cm (pd range 0.5-0.8 Torr.
cm). The measurements have shown that the discharge behavior in the ac circuit is equivalent to a series RC circuit. It is observed that the variation curve of discharge power P with the frequency f is approximately has a Gaussian shape. It is also observed that the curve of Pm- pd is the inverse of Paschen curve, where Pm is the maximum power in the frequency range. The time of breakdown is estimated from the curve of P- f.