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.
There is no doubt that each of the arts has a material from which the aesthetic achievement is built, so the researcher found that the art of theater, especially the show, whose artistic achievement is based on the body of the actor who emits the formal language (body language), is the focus of interest and active presence, because the body possesses its spiritual qualities that made him and the ability to The formation of things by (his body language), so the researcher studied this theatrical phenomenon and divided it into four chapters. In the first chapter, the research problem included the following question: (Is there a phenomenon of body language in the contemporary theatrical show "Imagine that" as a model) so It is of cognitive
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facing economic units operating in the environment sector of the Iraqi
industrial many pressures in its seeking to measure and evaluate its performance because of variables, today's corporate environment, as the case which makes looking for a methodology can be adopted to evaluate its performance with a more holistic, rather than being limited to traditional measures that are no longer enough to keep pace with rapid changes in today's corporate environment, which requires that measures of performance are derived from the strategy of unity and commensurate with the specificity of the environment in Iraq. Try searching discussion Ttormwhrat and performance measurement systems to suit the business strategies and directions of change
... Show MoreAbstract: Lymphoproliferative Disorders (LPDs) are a group of neoplasms affecting various cells within lymphoid system. Each type has different treatment a..70619
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The compliance is considered
This study aimed to deduce the net atrioventricular compliance which is affected the trans mitral blood flow.
This study focuses on study group of 25 patients (15 males
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The relationships between the related parties constitute a normal feature of trading and business processes. Entities may perform parts of their activities through subsidiary entities, joint ventures and associate entities. In these cases, the entity has the ability to influence the financial and operating policies of the investee through control, joint control or significant influence, So could affect established knowledge of transactions and balances outstanding, including commitments, and relationships with related to the evaluation of its operations by users of financial statements, including the risks and opportunities facing the entity assess the parties. So research has gained importance of the importance of the availability
... Show MoreThe aim of the work is synthesis and characterization of bidentate ligand [3-(3-acetylphenylamino)-5,5-dimethylcyclohex-3-enone][HL], from the reaction of dimedone with 3-amino acetophenone to produce the ligand [HL], the reaction was carried out in dry benzene as a solvent under reflux. The prepared ligand [HL] was characterized by FT-IR, UV-Vis spectroscopy, 1H, 13C-NMR spectra, Mass spectra, (C.H.N) and melting point. The mixed ligand complexes were prepared from ligand [HL] was used as a primary ligand while 8-hydroxy quinoline [HQ] was used as a secondary ligand with metal ion M(Π).Where M(Π) = (Mn ,Co ,Ni ,Cu ,Zn ,Cd and Pd) at reflux ,using ethanol as a solvent, KOH as a base. Complexes of the composition [M(L)(Q)] with (1
... Show MoreMost studies and research have tried to shed light on unemployment and employment in general, with less focus on the problems facing working women and the resulting social and economic consequences that threaten their human and professional lives. For women, working is one of the basic necessities for the sustainability of human life, and it constitutes an essential axis for both sexes and through it. It also gives a person the status and social status where the individual finds a ready opportunity to practice his intentions and desires, test his abilities and talents, and achieve his ambitions. The availability of full employment in general and the joining of women to the labor market is an important and fundamental factor in the sustai
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A new method for construction ion-selective electrode (ISE) by heating reaction of methyl orange with ammonium reineckate using PVC as plasticizer for determination methyl orange and determination Amitriptyline Hydrochloried drug by formation ion-pair on electrode surface . The characteristics of the electrode and it response as following : internal solution 10-4M , pH (2.5-5) ,temperature (20-30) and response time 2 sec. Calibration response for methyl orange over the concentrationrange 10-3 -10-9 M with R=0.9989 , RSD%=0.1052, D.O.L=0.315X10-9 MEre%=(-0.877- -2.76) , Rec%.=(97.230 -101.711) .
This research deals with issues of peaceful coexistence in foreign satellite channels directed in the Arabic language, trying to get acquainted with the most prominent of these topics dealt with the programs subject to analysis and the method of dealing with them and the most used journalistic arts in that.
The research adopted the descriptive approach and the method of content analysis for the purpose of studying the research community represented by the program «Shabab Talk» “Youth Talk” in the German channel Deutsche Welle (DW) and the program «Beina Sam wa Amar» “between Sam and Ammar” in the American free channel, by designing the content analysis form to subject
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