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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The research aims to shed light on the role of artificial intelligence in achieving Ambidexterity performance, as banks work to take advantage of modern technologies, artificial intelligence is an innovation that is expected to have a long-term impact, as well as banks can improve the quality of their services and analyze data to ensure that customers' future needs are understood. . The Bank of Baghdad and the Middle East Bank were chosen as a community for the study because they had a role in the economic development of the country as well as their active role in the banking market. A sample of department managers was highlighted in collecting data and extracting results based on the checklist, which is the main tool for the stu
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The research topics important topic of jurisprudence worship, a ruling Zakat ornaments
prepared for use, and touched the odds scholars in it. Stroll scholars say that there is no Zakat
on ornaments prepared for use have reported their evidence they and the owners say the other
of those who say should be directed to pay zakaat, and discuss those views and statement
Dafeeha of Sahihaa, and came up with a summary then, showed where the prevailing view
that I see in agreement of the transferee and reasonable. Ask Him to show us the right, and
thank God.
Many letters and theses written on the subject of consensus, as well as in measurement,
But we tried to address a topic of consensus
Building a blind measuring guide.
We have tried to explain the meaning of convening, then the statement of consensus in language and terminology and then the statement of measurement
Also, we have shown the types of consensus mentioned by the jurists, and this is how much was in the first topic, either
The second section included the statement of the doctrines of the blind in the matter, and then the evidence of each doctrine and discussed.
We followed it with the most correct opinion statement and concluded the research with some of the conclusions we reached through
search.
Unter dem Titel " Technische Methoden im Fremdsprachunterricht als eine neueste Methode im Fremdsprachlernen, die Spiele als Muster"
versteht man, dass die Forschung sich mit einer neuen Methoden im Fremdsprachunterricht beschäftigt. Von den neuen Methoden im Unterricht sind die Spiele. So man sieht in den letzten Jahren viele Artikel zum Thema Spiele im Fremdsprschunterricht. Davon gehen wir aus, dass die Spiele im Unterricht eine groβe Rolle spielt, denn diese Methode macht Lust, Spaβ im Lernenprozeβ. Die Spiele im Unterricht bezeichnen als ein Mittel, um Unterricht etwas Schönes , Nützliches und Lebendigs zu sein. Die Spiele sind vielfälltig und unterscheidet sich nach den Themen und Materialien. In dieser F
... Show MoreObjectives: The demand for orthodontic treatment is nowadays increasing significantly for aesthetic improvement and to correct various kinds of malocclusion, yet the prolonged treatment time remains the main obstacle. This review aimed to demonstrate various orthodontic techniques and highlight the evidence-based successful approaches used for acceleration of orthodontic tooth movement. Materials and Methods: Data and sources of information pertaining to accelerated orthodontic tooth movement premised on English-written articles were searched using electronic databases including Google Scholar, Scopus, PubMed and MEDLINE. Results: This review demonstrated the availability of different surgical and non-surgical methods to enhance tooth movem
... Show MoreProsthetic is an artificial tool that replaces a member of the human frame that is absent because of ailment, damage, or distortion. The current research activities in Iraq draw interest to the upper limb discipline because of the growth in the number of amputees. Thus, it becomes necessary to increase researches in this subject to help in reducing the struggling patients. This paper describes the design and development of a prosthesis for people able and wear them from persons who have amputation in the hands. This design is composed of a hand with five fingers moving by means of a gearbox ism mechanism. The design of this artificial hand has 5 degrees of freedom. This artificial hand works based on the principle of &n
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In this paper, the goal of proposed method is to protect data against different types of attacks by unauthorized parties. The basic idea of proposed method is generating a private key from a specific features of digital color image such as color (Red, Green and Blue); the generating process of private key from colors of digital color image performed via the computing process of color frequencies for blue color of an image then computing the maximum frequency of blue color, multiplying it by its number and adding process will performed to produce a generated key. After that the private key is generated, must be converting it into the binary representation form. The generated key is extracted from blue color of keyed image then we selects a c
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