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 is based on the basic idea that companies today are moving towards a new trend towards protecting the environment coupled with the increasing wareness of the pollution damage caused by these companies due to their operations and activities in the environment. The two main reasons that led the researchers to choose this subject is the need to adapt the companies themselves in response to successive developments, The great development was that companies moved from the sole economic responsibility of the business to social responsibility by emphasizing socially responsible profit. The problem of research is the knowledge of the availability of the dimensions of the green processing series in Kirkuk Cement Factory The re
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The modernity of election practices of the elections in Iraq, according to the democratic approach, has led to a struggle between political rival forces reflecting a deep pressure on the tools involved in the management, marketing or control of these elections across the general social level. Hence the problem of research resides in answering the following question: What is the nature and size of the pressures affecting the media performance of Al-Iraqia News channel before the legislative elections of 2018 in Iraq?
The objectives of the research were the following:
1. to identify the nature of the pressures that limit the Al-Iraqia News channel’s perfo
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The purpose of this research shed light on the analysis of the relationship between the knowledge gap and the strategic performance gap and diagnose the level of impact this relationship in building a learning organization, and sought search to achieve a number of goals, cognitive and Applied been tested nature of the relationship and effect between variables in a sample size (62) of the managers of banks civil in Baghdad (Baghdad, Gulf, Assyria, Union, Elaf) and focused research problem in question is bold is whether the analysis of the relationship between the knowledge gap and the performance gap strategic leads to recognize organizations need to shift to organizations educated, either in the side of the field was the pr
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The international organizations showed their interest in the marketable public relations, with their activities, means and strategies, they play a crucial role in marketing products, services and ideas of the institution. They are considered to be the link between the company and its public, They are responsible for presenting the institution to the public, with honest transmission of the information. This gives a good impression to the institution, in a way the institution and its products become consistent with the needs and interests of the public. Based on this, the research aims to identify the strategies used by the marketable public relations internationally. The r |
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Autorías: Hadeer Idan Ghanim, Ishraq Mahmood. Localización: Revista iberoamericana de psicología del ejercicio y el deporte. Nº. 3, 2021. Artículo de Revista en Dialnet.
Background: During acrylic resin processing, the mold must be separated from the surface of the gypsum to prevent liquid resin from penetrating into the gypsum, and water from the gypsum seeping into the acrylic resin. For many years, tin foil was the most acceptable separating medium, and because it's difficult to apply, a tin-foil substitute is used. In this study, olive oil is used as an alternative to tin foil separating medium for first time, and evaluating its effect as a separating medium on some mechanical properties such as (indentation hardness and transverse strength) of acrylic resins denture base comparing it with those processed using tin-foil and tin foil substitute such as (cold mold seal) separating medium. Materials and M
... Show MoreDAIRMD Professor Hayder R. Al-Hamamy, **Professor Adil A. Noaimi, **Dr. Ihsan A. Al-Turfy, IOSR Journal of Dental and Medical Sciences (IOSR-JDMS), 2015
Numerous integral and local electron density’s topological parameters of significant metal-metal and metal-ligand bonding interactions in a trinuclear tetrahydrido cluster [(Cp* Ir) (Cp Ru)2 (μ3-H) (μ-H)3]1 (Cp = η5 -C5Me5), (Cp* = η5 -C5Me4Et) were calculated and interpreted by using the quantum theory of atoms in molecules (QTAIM). The properties of bond critical points such as the delocalization indices δ (A, B), the electron density ρ(r), the local kinetic energy density G(r), the Laplacian of the electron density ∇2ρ(r), the local energy density
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Darcy-Weisbach (D-W) is a typical resistance equation in pressured flow; however, some academics and engineers prefer Hazen-Williams (H-W) for assessing water distribution networks. The main difference is that the (D-W) friction factor changes with the Reynolds number, while the (H-W) coefficient is a constant value for a certain material. This study uses WaterGEMS CONNECT Edition update 1 to find an empirical relation between the (H-W) and (H-W) equations for two 400 mm and 500 mm pipe systems. The hydraulic model was done, and two scenarios were applied by changing the (H-W) coefficient to show the difference in results of head loss. The results showed a strong relationship between both equations with correlation coefficients of 0.999,
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