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 topic of strategic intelligence is considered as important topics that acquires the attention of organizations, Because of its role in supplying the decision-making centers by strategic ideas according to the opportunities and threats facing the organization, in an effort to improve the performance of their organizations to reach the high performance organization.
A lot of organizations lack to strategy guides the strategic intelligence towards achieving high performance organization.
This research aims to determine the level of strategic intelligence that characterized the leaders of diseases and kidney transplant center in Medicine city. What is the application level of the
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Arzı Kanber/Kamber hikayesi Anadolu, Rumeli, Azerbaycan, Türkmenistan ve Irak gibi Türk dünyasının birçok yerinde birden fazla varyantı bulunan, çok sevilen ve yaygın olarak anlatılan aşk ve dramatik maceralı bir halk hikayesidir. Türk halk hikayelerinin en popüler olanlarından biri sayılan Arzı Kanber/Kamber hikayesi, Anadolu'nun birçok yöresinde bilinmesine rağmen Irak Türkmenleri arasında daha çok sevildiği ve yaygın olarak anlatıldığı tespit edilen birden fazla varyantından da görülebilir. Irak Türkmenleri arasında günümüze kadar hikayenin iki varyantı tespit edilmi
... Show MoreThe planning for the formation of administrative policies and guidance through leadership are important things for managing administrative processes and sporting activities. As both contribute in the stability of the administrative conditions, and their development in the sport federations, whether they both were attentive about team and individual Olympic Games. The two researchers observe that, there is a variation in the correct way of application. Particularly in the formulation of administrative policies and leadership describing it as, modern management standards for both team and individual Olympic Games in the Iraqi National Olympic Committee. That led to cause a misconception and lack of clarity for some administrators of those uni
... Show MoreIntroduction/Aim. Seminal fluid analysis (SFA) plays a crucial role in helping infertility clinics diagnose the underlying reason of male infertility. The aim of the study was to investigate seminal fluid patterns of male partners of an infertile couple with apparently fertile female partners. Materials and methods. A cross-sectional study was conducted between January 2019 and December 2022. Patients were attending consultations for delayed conception for more than 12 months with apparently fertile female partner. Results. Four hundred fifty-three patients were included in the study. The distribution of patients according to age groups showed that 277 patients were young, aged 21 - 30 years (61%). Two hundred sixty-two (58%) patien
... Show MoreThis study discusses the semiotic of the Islamic blazon - a related analytical study between the Islamic blazon and its visual publicity message. The aim of the current study is to explore the related relationship between the Islamic blazon and its visual publicity message. The sample is contained Five of Islamic blazon in the Mamelukes period which is between 1250 to 1517. The methodology is descriptive-analytical, and the result is that there is a clear relation between the Islamic blazon with its visual publicity message. This study's recommendation is to go towards analyzing the meanings of the cultural legacies of the Islamic civilization, and researching the implicit meanings accompanying these features leads to a deeper understand
... Show MoreThe aim of the research is to know the effect of a training program based on interactive teaching strategies on achievement and creative problem solving among fourth-grade students in chemistry of the directorate of education Rusafa first, the sample was divided into two groups, one experimental and numbering (29) students and the other control group numbering (30) students. The experimental group underwent the training program in the first semester of the year (2021-2022) and the control one studied according to the usual method. Two tools were built, the first being an academic achievement test consisting of (40) multiple-choice items, and the second a test of creative problem-solving skills in a chemistry subject and consisting o
... Show MoreThermal energy storage is an important component in energy units to decrease the gap between energy supply and demand. Free convection and the locations of the tubes carrying the heat-transfer fluid (HTF) have a significant influence on both the energy discharging potential and the buoyancy effect during the solidification mode. In the present study, the impact of the tube position was examined during the discharging process. Liquid-fraction evolution and energy removal rate with thermo-fluid contour profiles were used to examine the performance of the unit. Heat exchanger tubes are proposed with different numbers and positions in the unit for various cases including uniform and non-uniform tubes distribution. The results show that
... Show MoreMarketing Intelligence is one of the important methods of collecting information about competitors ' products and changes in customers ' tastes and needs that contribute to determining the policies to be followed in product development.
The problem of research, which seeks to be answered by the extent to which the companies in question have the appropriate and effective mechanisms to develop their products, and the nature of the relationship between the components of marketing intelligence and new product development policies. The importance of research is determined by the importance of obtaining important and necessary information to make the appropriate decision on the development of the new product an
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