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.
Purpose: The current research attempts to diagnosis the reflection level of Information Technology (IT) Capabilities (Architectural, infrastructure, human resources, relationships resources, and dynamic capabilities) at Baghdad soft drinks Company/Al- Zafaraniya to achieving the competitive superiority represented by indicators (Cost, quality, flexibility, delivery and innovation). Recognizing the importance of the subjects studied, and because of the importance of the expected results of the field under consideration.
Design/Methodology/Approach: The experimental method has been used, the questionnaire used to collect th
... Show MoreOrganizations must interact with the environment around them, so the environment must be suitable for that interaction. These companies are now trying to become Learning Organizations because it try to face that challenges may rise from its environments. The Learning Organization is a concept that is becoming an increasingly widespread philosophy in modern companies, from the largest multinationals to the smallest ventures. What is achieved by this philosophy depends considerably on one's interpretation of it and commitment to it. This study gives a definition that we felt was the true ideology behind the Learning Organization and Group Working. A Learning Organization is one in which people at all levels
... Show MoreAmis: NAFLD is considered to be the most common cause of liver conditions worldwide. Also, it is a primary reason that leads to coronary artery diseases, limiting blood flow to the heart. Therefore, This study aimed to evaluate the serum level of Nesfatin-1 and its ability to indicate the prognosis of CAD in patients with NAFLD. Material & Methods: one-hundred eighty Individuals were enrolled in the study, including In both genders, blood was collected from each Individual and sent to the laboratory for biochemical tests. Findings: Data from the current study showed a significant increase in Nesfatin-1 in the CAD group and a significant decrease in Nesfatin-1 in the NAFLD group compared to the control group. In addition, there w
... Show MoreThere were two types of plows used widely in agricultural fields in the country. The first plow was moldboard plow, while the second one was chisel plow. There were large numbers of Iraqi farmers that used chisel plow for such farming practices. Researchers found that moldboard plows gave the highest rate of carbon dioxide emission. They observed that that with chisel plows they got the lowest carbon dioxide emission. Chisel plow saved energy as compared to moldboard plow and the cost of using the chisel plows was less than the moldboard plows. Chisel plow decreased carbon dioxide emissions from the soil and improve soil properties. The benefits of using chisel plows were more than using moldboard plows.
In the name of of Allah the Merciful
Research Summary
This rule is one of the common rules between the sciences of the principles of jurisprudence and the jurisprudence rules. It is originally a fundamental rule because it relates to one of the topics of the science of the principles of jurisprudence, which is ijtihad. The ruling on reversing his ijtihad is permissible or not (1), and for this reason Ibn Al-Subki titled it in his book Al-Ishbah wa Al-Nazaer by saying: “What invalidates the judge’s judgment and what does not invalidate it.” ([2]).
The importance of this rule comes from the need for it by the judge, the mufti and the imitator, for the judge needs it to know the matters in which the ruling base
... Show MoreBackground : Polycystic ovary syndrome (PCOS) is the most common cause of infertility in reproductive-age women , it is an important harbinger of metabolic disorders. It has been reported that hyperamylasemia can be used as marker of ovarian cancer patients . The current study was conducted to evaluate amylase activity and to estimate the correlation of this enzyme with insulin and insulin resistance in PCOS patients. Methods: This study was conducted on forty five patients with PCOS in comparison to twenty five women as control. Fasting blood sample was taken from each subject and analyzed for amylase activity , FSH,LH, Insulin , proteins, and blood sugar , meanwhile insulin resistance was determined by HOMA-IR index. Results: The result
... Show MoreStubbornness is of the nature of the mean, we do not see it in the character of a person whose heart God filled with faith, wisdom and knowledge. And stubbornness does not fall into it except hearts that are arrogant, envious and objectionable, hearts that do not admit mistakes, and are not satisfied with the truth. Rather, you see humiliation,humiliation and shortcomings in returning to Him. He loves corruption * Except in humiliation, humiliation and shortcomings, the stubborn fall, even if they are proud when it is said to him, "Beware of God", pride takes him for sin, so his count is Hell, and his misery.
traces of stubbornness :key wor
... Show MoreObjective : Multiple sclerosis (MS) is a common neurological disease deeply linked with the immune-inflammatory disorders whereas the term (multiple) mostly refers to the multi-focal zones of Inflammation caused by lymphocytes and macrophages infiltration besides oligodendrocytes death. Accordingly , the dysfunctional immune system able to damage myelin ( a pivotal component of the central nervous system ) which responsible for communication among neurons. The aim of the present study is to innovate a biochemical relationship between MS and thyroid hormones (THs) by highlighting immunological responses and also to examine the action of Interferon beta (IFNβ) drug on thyroid hormone (THs) and thyroid stimulation hormone (TSH). Materials and
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