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 surgery Keywords: Non-surgical treatment of anal fissure, fissure in ano, sphicterotomy,botulinum toxin in anal fissures, glyceryl trinitrate. Chemical sphincteratomy, pharmacological sphincteratomy.
In this paper we have dealt with the word " בַּיִת" in the Book of Joshua because it makes one of those that highly employed the word בַּיִת" " in the Old Testament. The Book of Joshua comes sixth in the order of tanakh wich was written by Joshua son of Noon in Palestine during the fifteenth century B.C. and it covers a three-decade era extending from the death of Moses til the death of Joshua son of Noon.
The word " בַּיִת " in this paper refers to the place, where expressions are made by a noun modified by a noun . The modifier is"" בַּיִת , and the modified is another noun. Herein, we
... Show MoreCognitive-behavioral therapy is one of the most important relatively recent; treatment programs that attempt to modify behavior and control psychological disorders by modifying the individual's thinking style and awareness of himself and his environment, and cognitive reconstruction by replacing negative thoughts with positive ones. The current study aimed to know the effectiveness of a cognitive behavioral treatment program in reducing nervous fatigue among mothers of children with cerebral palsy. The sample on which the nervous fatigue scale was applied consisted of (30) mothers whose son suffers from cerebral palsy, and the results indicated that (24) mothers suffer from nervous fatigue. This sample was divided
... Show MoreIn this paper, split-plate airlift electrochemical reactor as an apparatus with new configuration for wastewater treatment was provided. Two aluminum plates were fixed inside the reactor and present two functions; first it works as split plates for internal loop generation of the airlift system (the zone between the two plates acts as riser while the other two zones act as downcomer) and second it works as two electrodes for electrocoagulation process. Simulated wastewater contaminated with zinc ions was used to test the performance of this apparatus for zinc removal by studying the effect of different experimental variables such as initial concentration of zinc (50-800 ppm), electrical current density (2.67-21.4 mA/cm2), init
... Show MoreThe study focuses on the problem that Iraq is approaching an increasing rate of literacy;the available data refers to a rate of (18% -19%). In addition to the fact that the generalcurrent role of the programs directed to literacy is not actually effective enough to limit the expansion of this rate.
The importance of this study highlights the fact that the Iraqi universities are an important tributary among the tributaries of human development, especially in spreading the education of the voluntary work in literacy field and confirming the connection between the students and their society and their role in solving one of the prominent challenges that face the development, i.e., literacy.
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... Show MoreThe 3D electro-Fenton technique is, due to its high efficiency, one of the technologies suggested to eliminate organic pollutants in wastewater. The type of particle electrode used in the 3D electro-Fenton process is one of the most crucial variables because of its effect on the formation of reactive species and the source of iron ions. The electrolytic cell in the current study consisted of graphite as an anode, carbon fiber (CF) modified with graphene as a cathode, and iron foam particles as a third electrode. A response surface methodology (RSM) approach was used to optimize the 3D electro-Fenton process. The RSM results revealed that the quadratic model has a high R2 of 99.05 %. At 4 g L-1 iron foam particles, time of 5 h, and
... Show MoreAim of the Study: The paper aims at identifying the extent of the role of strategic leadership represented by its four dimensions (administrative, transformational, political, moral) in fulfilling the requirements of university governance (Context, message and Goal, Management orientation, Independence, Issue, Sharing)
Methodology: A survey is applied to (107) members of the teaching staff at the college of Administration and Economics/ University of Mosul. To achieve the goals of the study, the researcher makes use of a number of tools such as: questionnaire, statistical tools and methods (repetitions, perce
... Show MoreBack ground: 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, so the aim of the study was to evaluate its effect as a separating medium on some physical properties such as (surface roughness, water sorption and solubility) of acrylic resins denture base comparing it with those processed using tin-foil and tin foil substitute such as (cold mold seal) separat
... Show MoreThe continuous technical development in the means of communication and information technologies has led to an increase in competition in the provision of service and product on the part of the organizations, as this competition does not know silence and stability on specific methods, but rather it is a world that is constantly moving and renewed in approaches, methods and approaches, and the focus of attention of integrated marketing communications practitioners are Customers, for them, organizations sell their goods, products, services, and ideas, and with them, they become stronger in competition.
This scientific study aimed to identify the trends of the initiators towards the integrated marketing communications of (the Emirates Tel
The issue of intellectual capital is a critical issue in the success and excellence of organizations, especially if it is linked to the management of customer experience, and because of the characteristic of the Iraqi environment, which affected all sectors, including the banking sector, it was important to discuss the types of intellectual capital and its relationship to the management of customer experience, especially when managers private banks, the importance of research lies in the linking of its variables to build the strategic capabilities of banks to achieve excellence and sustainability, it aims to diagnose the extent of interest in the types of intellectual capital and management of customer experience in the Iraqi ban
... Show MoreEMS in accordance with ISO 14001: 2015 is considered an entry point to reduce environmental impacts, especially the effects resulting from the oil industry, which is the main source of environmental pollution and waste of natural resources, since the second revision of the standard took place in September 2015. The problem of the research was manifested in the weakness in understanding the correct guidelines that must be followed in order to obtain and maintain the standard. The purpose of this research was to give a general picture of what is behind ISO14001:2015 and how it is possible to create a comprehensive base for understanding its application by seeking the gap between the actually achieved reality, standards requirements
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