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.
The research aims to reach a set of objectives concerning creation a clear vision about conceptual, philosophical and practical dimension of relations, and effects between knowledge management, costumer orientation and competitiveness to construct a framework of a pragmatic model as a solution to research problem and its questions which the main one is about the role of knowledge management and costumer orientation in competitiveness of business organizations. To achieving this goal, it was necessary to make, in priory, a review and discussion to the theoretical dimension of research variables to have a clear vision about constructing hypostatical research model implying a set of hypotheses which, by proving them in companies studied, repr
... Show MoreThe aim of organizational contemporary is development man power active, in spit-of there are littlie resources. But in the Iraqi environment there are too much resources with performance inhabiting. specially in the ministry of water resources (sample of this research), about dryness and lower levels of rivers. There for this study have some important variable, it is ethical leadership & transformational leadership as (independent variable), and Perceived organizational support(dependent variable). Over here to invest with authority on the problem of research, is weakness harmony between employed perception and the pattern of leadership. We find decline in of reaction of organ compound between the variable to weaken high perf
... Show MoreBACKGROUND: Genetic skeletal abnormalities are a heterogeneous group of genetic disorders frequently presenting with disproportionate short stature. AIM OF THE STUDY: To give an idea about the frequency of genetic skeletal abnormalities, and to find out whether these disorders are really increasing in the last 16 years or not. METHODS: During the period extending from (Jan, 1st 2003-April, 1st 2007), all cases of genetic skeletal disorders referred to the Genetic Counseling Clinic, Medical City – Baghdad who were born after 1991 were included in this study as the post-war group; the pre-war group, included all cases of skeletal disorders referred prior to 1991 (Jan., 1st 1987-Jan., 1st 1990). The demographic parameters, family history of
... Show MoreThe corrosion behavior of low carbon steel in washing water of crude oil solution has been studied potentiostatically at five temperatures in the range ( 303 –343 )K, at pH ( 4 ) and at pH (4,6,7,9,11 ) at (343K)..The corrosion potential shifted to more negative values with increasing temperature and the corrosion current density increased with increasing temperature, the corrosion current density (icorr) decreased with increasing pH in the rang ( 4 – 7 ) and it increased with increasing pH in the rang ( 9 – 11 ) at ( 343 K ), while the corrosion potential generally variation with increasing pH in the rang (4-11)at(343K. From the general results for this study can be seen that thermodynamic and kinetic function were
... Show MoreThis search seeks to know the trends of academics in the field of Press and audio, video and read press about paper press compared with continued development and widespread deployment of web journalism. This research belongs to descriptive studies which depends on sample survey approach adopted by five-meter design measuring trends. It contains 28 items having applied honesty and reliability transaction and the scale form is distributed to the sample studied of about 110 professors and then the researcher collects them and then applying the appropriate statistical program to get the results. This search seeks to know the trends of academics in the field of Press and audio, video and read press about paper press compared with continu
... Show MoreThe Strategy of employees' empowerment, organizational performance and total quality management represent three informative which were and still the hub of many studies and researches including the current study. The higher education is considered one of the most important services sectors and the main development as well as the civil progress in the society. It is the main source that provides the organizations with the human resources having scientific or practical professions. So Higher Education has been chosen especially Baghdad University as a sample of the study. The study problem is concentrated to find answers of the following questions: What the level of the powers mandate in the organization concerning the
... Show MoreThe research aims to achieve a set of objectives, the most important of which is determining the extent to which the auditors of the research sample in the Federal Bureau of Financial Supervision adhere to the requirements of the quality control system according to the Iraqi Audit Manual No. The federal financial / research sample with the quality control system according to the Iraqi audit guide No. 7), and the researcher seeks to test the main research hypothesis and sub-hypotheses, and to achieve this, a questionnaire was designed by (Google Form) and distributed electronically to the elements of the research sample, Through the statistical package program (SPSS), the results of the questionnaire were analysed. In light of the applied
... Show MoreThe present paper focuses on examining the style of both the civilized dialogue of Prophet Hud (PBUH) in the Glorious Qur'an, and the debated dialogue of Aad’s people. The study consists of an introduction which shows the importance of the civilized dialogue and its significant impact on containing, accepting, and persuading the other in peaceful ways without intolerance and violence. Then, the conditions and techniques of the civilized dialogue and its types have been mentioned. This is followed by the practical side of the study, which involves examining stylistically the techniques used in Hud’s (PBUH) civilized dialogue to be invested later in people’s future conversations. It is also concerned with investigating stylistically
... Show MoreThe interest in pre-service teacher training has become influential in teaching English as a foreign language, and the purpose of this training course is to prepare qualified teachers to teach effectively through the application of this technique by undergraduate students. This research aims to find out the effect of using the seven principles of good practice as a teaching technique on the fourth stage student-teachers’ performance at the College of Education for Women/University of Baghdad, during the academic year 2017-2018. The sample includes (60) students selected according to the stratified sampling method. The observational checklist used by the department to assess the student teachers’ performance during the practicum perio
... Show MoreThis paper aims to verify the existence of relationships between product innovation and the reputation of the organization. The study problem is that the State Organization for Marketing of Oil (SOMO) system is inflexible in terms of marketing procedures and needs innovative, unconventional methods in innovating its products and improving performance. The reputation of the organization. The importance of the study lies in that it is an attempt to raise the interest of SOMO in its approach to the research variables in order to enhance its competitive position in the future and improve the marketing business environment, which contributes to enhancing the reputation of the organization by product innovation. The study sample
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