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 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
... Show MoreGas sensors are essential for detecting noxious gases that have a detrimental effect on people's health and welfare. Carbon quantum dots (CQDs) are the fundamental component of gas detectors. CQDs and graphene (Gr) were prepared using the electrochemical method. The gas sensitivity of these materials was evaluated at different temperatures (150, 200, 250 °C) to assess their effectiveness. Subsequently, experiments were conducted at different temperatures to ascertain that the combination of CQDs and Gr, with various percentages of Gr and CQDs, exhibited superior gas sensitization properties compared to CQDs alone. This was evaluated based on criteria such as sensitivity, recovery time, and reaction time. Interestingly, the combination was
... Show MoreWe investigate mathematical models of the Hepatitis B and C viruses in the study, considering vaccination effects into account. By utilising fractional and ordinary differential equations, we prove the existence of equilibrium and the well-posedness of the solution. We prove worldwide stability with respect to the fundamental reproduction number. Our numerical techniques highlight the biological relevance and highlight the effect of fractional derivatives on temporal behaviour. We illustrate the relationships among susceptible, immunised, and infected populations in our epidemiological model. Using comprehensive numerical simulations, we analyse the effects of fractional derivatives and highlight solution behaviours. Subsequent investigatio
... Show MoreMany of researchers have written about social responsibility and business strategy and competitive advantage, and they have given particular attention to the relationship between economic and social responsibility , but what is missing in this aspect is how the economic units that use their core competencies to advance social responsibility initiatives so that they can achieve a significant competitive advantage and create value for it ?
The current research aims to verify the view that "the economic and social objectives in the long term is not contradictory in nature but complementary objectives essential", as well as make sure that the s
... Show MoreThe levels of shooting in basketball not very good appears un healthy phenomenon for age stages especially youth players on Iraq and therefore there is lower level in skills especially shooting that seems the players represent their players not good levels which cause difficult in choosing players for youth national team. The research sample were youth teams in Baghdad for season 2012-2013 their birth 1996 and the number teams (7) and after getting results and treat it statically the important ones were : there is a large number of failure attempts on success ones in basic shooting in basketball for youth teams in Baghdad teams (2012-2013) season and basic shooting have effective participation (positive relation) in youth teams ranking in B
... Show MoreThe Braille Recognition System is the process of capturing a Braille document image and turning its content into its equivalent natural language characters. The Braille Recognition System's cell transcription and Braille cell recognition are the two basic phases that follow one another. The Braille Recognition System is a technique for locating and recognizing a Braille document stored as an image, such as a jpeg, jpg, tiff, or gif image, and converting the text into a machine-readable format, such as a text file. BCR translates an image's pixel representation into its character representation. As workers at visually impaired schools and institutes, we profit from Braille recognition in a variety of ways. The Braille Recognition S
... Show MoreThis review examines how artificial intelligence (AI) including machine learning (ML), deep learning (DL), and the Internet of Things (IoT) is transforming operations across exploration, production, and refining in the Middle Eastern oil and gas sector. Using a systematic literature review approach, the study analyzes AI adoption in upstream, midstream, and downstream activities, with a focus on predictive maintenance, emission monitoring, and digital transformation. It identifies both opportunities and challenges in applying AI to achieve environmental and economic goals. Although adoption levels vary across the region, countries such as Saudi Arabia, the UAE, and Qatar are leading initiatives that align with global sustainability targets.
... Show MoreThe primary goal of root canal treatment (RCT) is to expel the presence of any necrotic or vital tissue, microbes and their byproducts from the canal space before press forward with the following steps of the RCT procedures. Although this is difficult to attain, various strives had been practiced by employing chemical and mechanical methods to eliminate as much microorganisms as possible and make the canal space valid for the obturation materials to be received. The aim of this review is to demonstrate some of what new remedies that could be used as root canal disinfectant by summarizing the recent studies regarding the efficacy of different natural products against the most persistence microbiota that could be responsible for most
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