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 problem of research was the lack of research that dealt with issue of the job design approach that is more suitable for knowledge work, therefore, the research aims to determine the impact of job enrichment, and knowledge capitalon strategic success, starting from the hypothesis that there significant impact of job enrichment and knowledge capital on strategic success, to achieve this goal the researchers from the theoretical literature and related studies conclude to the construction of the scheme shows the hypothetical relationship between the variables, which was adopted job enrichment as independent variable while knowledge capital plays two roles, the first as an independent variable and the second as an intermediate
... Show MoreBackground. The motor response is a fundamental ability that is evident during any physical or motor activity. However, the need for this ability varies from one sport to another and depends on the specific skills required in each sport. Objectives. This study aims to compare the average motor reaction times of the arm and leg among handball, basketball, and volleyball players aged 14 to 16 years. Methods. The sample included 30 players aged 14-16 years from the sports talent care center, evenly distributed on handball, basketball, and volleyball. Standardized tests were used to measure the speed of motor response, including the Batak Micro test for hands, which records the number of responses to light stimuli in 30 seconds, and the Saqer t
... Show MoreThe paper attempts to find out the elements of picaresque novel in selected English and Iraqi novels. It studies these elements in Henry Fielding’s Joseph Andrews and Adil Abduljabbar’s Arzal Hamad Al-Salim. The paper is divided into four sections. The first is an introduction to the picaresque novel. It gives a definition, a historical background, and the elements of the genre. The second section studies Fielding’s novel focusing on the elements of this type of novel and how it affects the story itself. The paper follows the novel from the beginning to the end showing these elements. The third is dedicated to Abduljabbar’s novel and how the elements of picaresque genre appear in the novel and play an important role in its developm
... Show More- coli K12 and B. subtilis 168 were investigated for their cadmium and mercury tolerance abilities. They were developed by UV mutagenesis technique to increase their tolerances either to cadmium or mercury, and their names then were designated depend on the name and concentration of metals. E. coli K12 Cd3R exhibited bioremediation amount of 6.5 mg Cd/g dry biomass cell. At the same time, its wild-type (E. coli K12 Cd3) was able to remove 5.2 mg Cd/g dry biomass cell in treatment of 17 mg Cd /L within 72 hours of incubation at 37 °C (pH=7) in vitro assays. The results show that E.coli K12 Hg 20 was able to remove 0.050 µg Hg/g dry biomass cell
Abstract
That Iraq's dependence on the revenues of the oil product in financing its development programs and growth rates , Making the economy affected by external forces represented by fluctuations in crude oil prices in the global market, Which is directly reflected on the performance and efficiency of the Iraqi economy.
The study adopted its objectives to analyze the time series for the period (1988 - 2015) through the use of standard and statistical methods, Four standard models were estimated to reach those targets, Where the results of the stability test showed instability of most variables at their original level, But to achieve stability when taking the first differences, While the result
... Show MoreThere are many studies that discussed the famous museum's graveyards in the Islamic worlds, to study the lives of these figures, there are many difficulties for their studies because the first we need the regularity and history information, and many sciences support, such as in language, geography information.
I am studying the research from Maraqid Al-Maaraf book by Harz Aldeen, the book has large members about the persons have graved in Persian Country in the middle ages, there are more than (30) figures in my study, I have studied every figure in this research depending on the sources and references books.
The habitat type and food availability always influence the population size of many
organisms. Bird’s feeding pattern should be abstracted to complete avian community structure
data. The agronomy main research farm of Orissa University of Agriculture and Technology
is a well-managed multi-crop agro-ecosystem which provides a suitable ground for ecological
research. In a multi-crop farmland, the association of Barn Swallow Hirundo rustica Linnaeus,
1758, with the Indian mustard Brassica juncea (L.) Czernajew, 1859 crops have been
recorded for the first time while hovering only on this field. A flock of Barn swallows was
recorded in 32 field visits while flying continuously over the Indian mustard field after
flow
The capital banking foundation stone upon which the bank in the practice of business activities, the more capital a good financial adequacy of the increased bank's ability to grant credit and expand the various activities and provide a safety element for depositors and other sources of funding to achieve profits and increase the trading volume of the shares, causing the rise the rate of return for the shares of banks and have the Central Bank as head of the banking system by issuing instructions capital increase banking, according to the requirements of economic development and increase gross domestic product by supporting investment projects that are financed through banks, the research aims to show the extent of the banks commitment to
... Show MoreOver application courier company (DHL) to keep the quality of service to achieve customer satisfaction the adoption of precedence delivery time - A prospective study))
Become attention to quality is a global phenomenon, and I took organizations and governments around the world attaches special attention, but we can say that quality has become the first function for many organizations, and has become a management philosophy
