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.
This study develops a systematic density functional theory alongside on-site Coulomb interaction correction (DFT + U) and ab initio atomistic thermodynamics approachs for ternary (or mixed transitional metal oxides), expressed in three reservoirs. As a case study, among notable multiple metal oxides, synthesized CoCu2O3 exhibits favourable properties towards applications in solar, thermal and catalytic processes. This progressive contribution applies DFT + U and atomistic thermodynamic approaches to examine the structure and relative stability of CoCu2O3 surfaces. Twenty-five surfaces along the [001], [010], [100], [011], [101], [110] and [111] low-Miller-indices, with varying surface-termination configurations were selected in this study.
... Show MoreThe purpose of this study was to investigate the effect of a Cognitive- Behavioral Training Program in reducing Problems Solving among a sample of education university College Students, the study sample consisted of (50) students were randomly assigned to two groups: experimental, and control; (25) students per group, the results of (ANOVA) revealed that there were significant differences at (p < 0.05) between experimental and control group in Problems Solving level, while there were significant differences between both groups in achievement. The researchers recommended further studies on the other variables which after training students on the method of solving problems and techniques to reduce stress.<
... Show MoreThis research is a modest effort to talk about the great world of ancient lineage, Imam Majd al-Din Abu Saadat, known as Ibn al-Atheer island, through the statement of his name, surname, nickname, family, elders and his pupils and his most important works.
It also deals with the modern research on his famous book in the field of modern science called (the end in the strange talk and impact), which is one of the most wonderful books of modern and especially the strange talk, through the scientific effort of the Imam and the importance of the book and methodology, and the most prominent aspects of the service and care of Ibn Al Atheer For the modern stranger, which boils down to two aspects:
First: the linguistic rooting of the stran
Diversity of the aspects of analyzing a specific linguistic issue is considered to be a
familiar phenomenon in learning Arabic in which – at different levels- various linguistic
aspects and phases – sometimes – are involved in a linguistic issue . In this paper , the
problematic issues during linguistic analysis are taken into an account. The Holy Quran
interpretation books include many Quranic expressions which have a lot of meaning described
by different interpreters , from them this paper has selected only one expression ( = كفاتا
receptacle ) from the verse "Have we not made the earth a receptacle " ( Al- Mursalat verse 25
) , this paper believes that this expression is sufficient display the interpret
To the Banks capital several uses, including the protection of deposits and this was approved by the Basel Committee, And Finance long-term investments which intended to investment in fixed assets that are essential to the continuation of banking activity, Fixed assets not financed from the funds of the deposit, but the owner equity do this jop. the current research tries to prove the effect of banks capital on fixed assets for a sample of iraqi private banks (bank of baghdad and Iraqi middle east Investment bank), for the period from 2011 until 2014. The research concluded that the capital of bank of baghdad affect on his total fixed assets by (84%), and the capital of Iraqi middle east Investment bank affect on his total fixed assets b
... Show MoreThe research aims to identify the factors affecting the customer and their impact desire for market share in a competitive market National Insurance Company, where he was after the tremendous developments that have taken place in the insurance sector, crowded markets, private companies and the intensified competition among those companies on one side and public sector companies, including national insurance company on the other hand, increased attention and study in a big way the customer and the factors influencing the desire. As the national insurance company ascertains its targets once the sale of insurance documents only, but by knowing the tendencies and aspirations of current and prospective customers a way that helps to strengthen
... Show MoreThe Local and Global Corporations are suffering of managerial and financial corruption phenomena, which leads them to loss and bankruptcy. So, it is necessary to search for tools which help prevent phenomena like this, and one of these tools is (corporate governance) which represent controlling tool that contribute in reducing corruption. this study aims at modifying (corporate governance system)in order to make it suitable with Iraqi government Corporations. the study depend upon main hypothesis which is (the performance level of the strategic perspective of governance system is depending upon work according to the perspective dimensions itself. From the main conclusions:-It is possible to building a strategic perspective
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