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 surgeryKeywords: Non-surgical treatment of anal fissure, fissure in ano, sphicterotomy,botulinum toxin in anal fissures, glyceryl trinitrate. Chemical sphincteratomy, pharmacological sphincteratomy.
The organization of sporting activities at the local and international levels requires a lot of money, which has increased interest in marketing in the sports field, as it is one of the modern topics that represent the basic knowledge needed by the sports marketer and which represents one of the basic concepts to enhance the benefits and returns of sports clubs. The research problem was the weak awareness of the members of the administrative body of Iraqi sports clubs of the role of sports marketing in the dimensions of competitive superiority and not exploiting them in the optimal way that enables clubs to achieve competitive superiority. The research aims to know the role of sports marketing in competitive superi
... Show MoreSocial protection meets different aspects of the needs of vulnerable groups, such as the economic, health, education, and family relations and ties in the Iraqi society. This is because vulnerable groups have suffered from social and economic influences that have negative implications on the social reality as a whole. Poverty is a case in point, which paved the way to frequent setbacks that have led to social structure instability. Accordingly, the present study aims to examine the role and effect of the Net of Social Protection Program in equally distributing social protection to curb or mitigate any negative consequnces that might happen to the poor segments and vulnerable people, who are succeptible to shocks, such as: the orphans, un
... Show MoreThe research seeks to identify the effectiveness of a selective program in modifying irrational thinking that causes anger among an important class of societies in general. namely teachers. Specifically female teachers because of the pressures they suffer because of the nature of this profession. It may develop into anger outburst, which may cause irrational thinking arose as a result of the different situations they are going through. The sample of the program consisted of (12) teachers in Egypt, from different educational sectors. The researcher intended to clarify the emotion of anger and the irrational thoughts associated with it and the contribution of the selective counseling program in modifying those irrational thinking. This was
... Show MoreThe objective of this study is to determine the extent to which the determinants of organizational support contributed to enhancing the mental status of banking services in a number of banks in Dohuk governorate in order to diagnose the correlation between the perceived organizational support and the mental status of services. Availability in the environment of banks and to enhance the mental position from the point of view of customers as the main hypotheses focused on the nature of the relationship between the dimensions of research among them has been tested these hypotheses using statistical and descriptive methods have been The study concluded that the contribution of organizational support, which is
... Show MoreThe study included adding antimony oxide to mixtures of coating metal surfaces (Enameling), after it was selected ceramic materials used in the coating metal pieces of the type of steel and cast iron in two layers. The first is called a ground coat and the second is a cover coat.
Ceramic materials layer for ground coat have been melted down in
platinum crucible at a temperature of 1200oC to prepare the glass
mixture (Frit). It was coated on metals at a temperature of 780oC for
two minutes, while the second layer was prepared glass mixture
(Frit) at a temperature of 1200oC, but was coated at a temperature of
760oC for two minutes.
Underwent tests crystalline state of powders (Frits) and enameled samples using X-ray di
Because of its importance in the world, Middle East area is one of the competition areas between the major and great powers. Among those powers are Russia and United states of America. The competition between these two powers to control Syria is greatly clear since 2011. It is also one of the most important subject in the international politics. This importance comes from the importance of Russia and the United States of America besides importance of the Middle East. At the end of the cold war, United States of America maintained its role in the international system and became the only pole that dominated the international affairs while Russia tried to overcome the challenges inherited from the former Soviet Union, and it succeeded in th
... Show Morestructural and electrical of CuIn (Sex Te1-x)2
The way artists deal with body in their artistic works has had so many forms and methods, whether as an object for their drawings or as a material to create live artistic performances that relate to the idea of correspondence and interaction between different artistic categories such as: drama, dance, and painting as it is the case of the artist Marina Abramovic who has always used her body as an artistic unit to generate meaning and to perform her lively shows.
To go deeper into her career, our work was divided into 3 sections:
The first section was devoted to follow the main artistic stages that her body had gone through, starting with paintings she performed using concepts based on acting, simulation and nudity and ending wi
Some children are suffering from introversion in kindergartens , so it must be confront and obviated by specialists because it will inevitably lead to unsatisfactory results reflect negatively on the individual and the community together . And the introvert child is a miserable child incapable of social interaction or give - and - take with colleagues , lack of integration of the child to life leads to the obstruction of participation with his peers in various activities. Introversion causes a real emotional deficit to the children of kindergartens which limits of possibility of their intellectual development and mental growth and that because of their isolation and poor focus in education
... Show MoreTigris River is the lifeline that supplies a great part of Iraq with water from north to south. Throughout its entire length, the river is battered by various types of pollutants such as wastewater effluents from municipal, industrial, agricultural activities, and others. Hence, the water quality assessment of the Tigris River is crucial in ensuring that appropriate and adequate measures are taken to save the river from as much pollution as possible. In this study, six water treatment plants (WTPs) situated on the two-banks of the Tigris within Baghdad City were Al Karkh; Sharq Dijla; Al Wathba; Al Karama; Al Doura, and Al Wahda from northern Baghdad to its south, that selected to determine the removal efficiency of turbidity and
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