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.
This research aims to Presented model can be applicable – in the frame of current accounting implementations - to measure environmental effects and disclosure then in the financial statements of economic entities after determined the environmental performance scopes of environmental activities that is works by this entities , because of importance of accounting information which presentation by accounting systems which's effectiveness tool on hand of decision maker about site plans and goals and drawing policies aims protection environment sustainable the represented of naturalism wealth elements . The researcher could be able to application his suggested model which's proof the ability to environmental accounting measurement and discl
... Show MoreThis study ,the samples were collected from "118 patients " suffering from burn wound contaminated with Pseudomonas aeruginosa and 100 health individuals (male and female ) as a control group ,the samples were wound swap and blood sample . Chromatography technique was employed to extract and purify cell wall containing lipopolysaccharide by using P. aeruginosa isolate ATCC 15692,the purification done by addition of ammonuium sulfate, sodium dodecyl sulfat (SDS) anddialysis, gel filtration chromatography by using sepharose-4B. Immunogenicity of LPS component was determined by mice injection under the skin ,then Ab concentration agai
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Objectives: The aim of the study is to evaluate the information of caregivers concerned emergency care for the elderly and to identify the relationship between caregiver information and their educational level, years of service and training courses. Methodology: A quasi-experimental study was conducted in the Geriatric Care Home in Baghdad City (the governmental and private geriatric care home ) for the period from October, 14th , 2018 to March, 20th , 2019 to find the effectiveness of the instructional program on caregivers knowledge about emergency care for the elderly.. A purposive sample (non-probability) was consisting of (30) males and females caregivers, the sample was selected from geriatric care home in Baghdad city .To implemen
... Show MoreThe study aimed at identifying the strategic gaps in the actual reality of the management of public organizations investigated to determine the strategy used based on the study model. The study relied on the variable of the general organization strategy in its dimensions (the general organization strategy, the organization's political strategy and the defense strategy of the organization) The sample of the study was (General Directorate of Traffic, Civil Status Directorate and Civil Defense Directorate), formations affiliated to the Ministry of the Interior, for the importance of the activity carried out by these public organizations by providing them In order to translate the answers into a quantitative expression in the analysi
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The challenges facing today's multi-customer and this is due to the multiplicity of products and speed in launching new products so search came to reveal the reveal the of the new product classification standards through a relationship (good products, low interest products, useful products and products desired) and the customer emotionally blackmail through deportation (fear, obligation and guilt). dentified the problem of the research in several questions focused on the nature of the relationship between the variables of research, and for that outline supposedly to search it expresses the head of one hypothesis and branched out of which four hypotheses subset, but in order to ensure the validity of the ass
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Abstract:
Inclusive education has experienced a number of positive educational trends and developments in many different countries, typically by recognising that all students, including those who have special educational needs (SEN), have a right to education. Inclusion of children with SEN in mainstream schools, alongside their peers, has become a major concern for interested educators, professionals and parents in many countries around the world. The reasons for this trend are due to a number of factors such as the increasing attention to the role of education in achieving social justice for pupils with SEN; the right of individuals with SEN to be educated along with their typically developing peers in mainstr
... Show MoreThe objective of this research is to develop a method for applying financial derivatives in the local environment to reduce the risk of foreign exchange rate fluctuations to enhance quality of accounting profits through Financial reporting to local units In accordance with international financial reporting standards, To accomplish this objective was selected a sample of Iraqi units exposed to the risk of fluctuations in foreign currency rates, As the research found:
- many companies and banks in the local environment a lot of losses due to fluctuations in foreign currency exchange rates.
- that financial derivatives in the Iraqi environment represent
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This study was conducted in 2018, at Technical College of Applied Sciences, Sulaimani Polytechnic University, Kurdistan Region-Iraq. The aim of the study was to determinate nutritional compositions and some elemental contents in marketable white button mushroom (Agaricus bisporus) that is collected in local markets of Kurdistan Region-Iraq. Five different samples (A: Penjwen product fresh, B: Sulaimani product fresh, C: American caned, D: Valencia Netherlandcaned and E: Erbil product fresh) were collected to be observed. The elements were analyzed by Atomic Absorption Spectrometry methods, and their chemical compassions were determined, too. The collected data were analyzed by One Way ANOVA. The highest fat, protein, fiber and d
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The research aims to show the dimensions of organizational trust represented by (administrative policies opportunities for innovation and self innovation and self- realization,availability of information,prevailing organizational values) and its reiationship to achieving the strategic position of banks represented by formation of expectations,buiiding networks,learning operations As the research was applied in each of the banks (middle east)Iraqi investment,Al-Ahly Iraqi, Business Bay, Al- Mansour investment bank),the qusestionnaire was adopted as a tool to collect data and information from the sample number (138)who are in the site (department director, division ,M.division director ,division officer, unit officer)the statistica
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