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.
with an organized propaganda campaign. This military campaign was helped to formulate its speech by many institutions, research centers, and knowledge and intelligence circles in order to mobilize public opinion gain supporters and face the opponents by different means depending on a variety of styles to achieve its required effects.
After the US occupation of Iraq, US media fighters sought to influence the Iraqi public opinion and making them convinced them of the important presence of US military forces in Iraq which necessitated finding its justification through the use of persuasive techniques in its intensive propaganda campaigns.
This research discusses the most important
The main purpose of this research aims to measure the role of banking strategies marketing in achieving competitive advantage within a sample of Iraqi private banks, and in order to achieve this purpose, the researcher depend on number of sober research approaches which consisted of descriptive, analytical and practical methodologies, to strengthen concepts addressed by the research, size of the sample was (56) individuals which makes up the senior leadership represented (Chairman and members of the Board of Directors, Commissioners and their assistants and department heads) while the primary tool for research (questionnaire), which has been designed based on a number of solemn scientific metrics, after adapted these metrics commen
... Show MoreABSTRACT Background: work-related musculoskeletal disorders represent an important occupational health issues among dentists especially neck and low back complaints. Biomarkers of tissue damage as results of occupational physical demands could be used for detection of work related musculoskeletal disorders. Aim: The aim of this study was to assess work- related musculoskeletal disorders, physical work load index, selected salivary biomarkers (Creatine kinase and C - reactive protein) and to find the relation among them. Subjects and Methods: Study participants are consisted of 112 dentists. They were selected from college of dentistry /Baghdad University, health care center in Bagdad city. They were of both gender and aged between 40-45 yea
... Show MoreBackground: Diabetes mellitus (DM) could be regarded as a set of chronic metabolic disorders which have a common aspect of hyperglycemia. The resistance in the peripheral actions of insulin or impaired insulin secretion could be the reason hepcidin which is a peptide hormone derived from liver, in systemic iron homeostasis is an essential regulator, and its lopsided production participates in the pathogenesis of iron disorders in spectrum. Osteoporosis often accompanies many diseases like ß-thalassemia, hemochromatosis, sickle liver diseases, cell disease and hemosiderosis featured by iron overload, evidences suggest that Iron overload and iron deficiency are suggested by evidences that they affect bone in a negative way, acting
... Show MoreThis study examined the tagged (the matter, its ruling, and examples of its applications in Ahmadiyya interpretations), the study of devising formulas of commissioning, especially the matter from the book of interpretation, which is: (Ahmadiyyeh’s interpretations), and the contemplative of the nature of (Ahmadiyya’s interpretations) realizes that the cognitive, linguistic and juristic knowledge product and the verses of judgments And other is the focus of this immortal travel, as it is truly a comprehensive book containing what the students of knowledge, scholars and the general public need in terms of interpreting the legal verses, and it is not possible to reach an understanding of the Book of God Almighty, and to clarify his purpo
... Show MoreObjective: To assess the impact of a social support for pregnant women upon their pregnancy outcome Methodology: A descriptive purposive study was used to assess the impact of a social support on their pregnancy outcomes. The study was conducted from (22 \ September \ 2020 to 15 \ February \ 2021). A non-probability sample (purposive sample) was selected from 100 women. Data were collected through an interview with the mother in the counseling clinic, during the third trimester of pregnancy, as well as after childbirth in the labor wards to assess the outcome of pregnancy. Data were analyzed through descriptive statistics (frequency and percentages). Results: The most important thing observed in this study was the positive pregnancy outcome
... Show MoreThe study aims to build a model that enhances trust-building for public and private banks to compare and determine the significant differences between public and private banks, by testing the impact of governance mechanisms (transparency, accountability, justice, independence, and social responsibility) (Agere, 2000) on trust-building strategies (trust and trust building, people management, work relations, training and development, leadership practices, and communications) (Ngalo, 2011; Stone et al., 2005), to indicate the level of employees’ awareness of the theoretical contents of the two variables and their importance to banking work, with the aim of improving performance. The main question is the role of governance mechanisms
... Show MoreBackground: Oral pyogenic granuloma (PG) is a clinicopathological entity that could develop due to the reaction to a variety of stimuli, such as low-grade local irritation, traumatic damage, and hormonal stimulation. There are two histopathological types of pyogenic granuloma; lobular type -capillary hemangioma (LCH) and non-lobular type; with PG,LCH has highly vascular, diffuse capillary growth while non- lobular variant mimicking granulation tissue with heavily inflammated stroma. The study aims were to review the clinical and histopathological spectrum of an oral pyogenic granuloma from different intraoral sites in order to avoid diagnostic pitfalls associated with similar morphological lesions and to determine
... Show MoreMaximum power point tracking (MPPT) is used in photovoltaic (PV) systems to enhance efficiency and maximize the output power of PV module, regardless the variation of temperature, irradiation, and the electrical characteristics of the load. A new MPPT system has been presented in this research, consisting of a synchronous DC-DC step-down Buck converter controlled by an Arduino microcontroller based unit. The MPPT process with Perturb and Observe method is performed with a DC-DC converter circuit to overcome the problem of voltage mismatch between the PV modules and the loads. The proposing system has high efficiency, lower cost and can be easily modified to handle more energy sources. The test results indicate that the u
... Show MoreThe reconciliation of tax reconciliation is one of the legal methods used by the financial authority in Iraq, which is done with the taxpayer
The research dealt with the weakness of tax revenues for many reasons, including tax evasion, which led to the search for ways to reduce evasion to increase the tax revenue, and settlement reconciliation one of these means .
The research proceeded from the premise that the use of a more broadly settled settlement would govern the tax evasion of taxpayers.
The researchers used a series of studies and previous research, books and other sources related to the subject of research, and this was done through the theoretical framework, and the practical aspect that included the fin
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