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 free piston engine linear generator (FPELG) is a simple engine structure with few components, making it a promising power generation system. However, because the engine works without a crankshaft, the handling of the piston motion control (PMC) is the main challenge influencing the stability and performance of FPELGs. In this article, the optimal operating parameters of FPELG for maximising engine performance and reducing exhaust gas emissions were studied. Moreover, the influence of adding hydrogen (H2) to compressed natural gas (CNG) fuel on FPELG performance was investigated. The influence of operating parameters on in-cylinder pressure was also analysed. The single-piston FPELG fuelled by CNG blended with H2 was used to run the expe
... Show MoreThe research aims to measure the impact of the quality of the audit on the Earnings Quality, for a sample of private joint stock companies listed on the Iraq Stock Exchange, as the research sample included (14) private and listed joint stock companies in issuing their financial statements for the period from (2010-2018), as well as companies The audit offices in charge of auditing these companies, which number (18) companies or an audit office, and the research relied on two main models for measurement, as the first model reflects the assumed relationship between independent variables represented in the characteristics of external audit quality and measuring the extent of its impact on the dependent variable represented in the Ea
... Show MoreThis research aims to show the sight at the importance of the private banking sector in Iraq and its role in financing of the investment projects , of the ability of Central Bank's decision to increase the minimum limit of capital for private banks to provide support to the economic activity and the development in Iraq. In addition to illustrate the importance of the capital increase, with a, and taking into notice the most important determinants that can stand in front of these banks in the beginning of the decision implementation, which in turn can lead to the most important proceedings that can contribute in the support of banks to implementation the decision. Also, the research has highlighted the most important ways through wh
... Show MoreThe research discusses with organizational spirituality and its implications on the organizational performance in the General Company for Food Industries in Abu Ghraib (Baghdad). The aim of the research was to determine the contribution of organizational spirituality in the organizational performance of the surveyed company. In order to achieve the objectives of the research، two main hypotheses were adopted. Several sub-hypotheses centered on the relationship between organizational spirituality and organizational performance in terms of its dimensions (Meaning work، self-esteem، community affiliation،
... Show MoreThe self-evident truth existing in today's business environment is the continuity of change and its continuity and turmoil, also its increase over time as it is more abundant, abundant, wide and complex than ever before, and it is the dominant feature in the business environment, as different organizations and operating units can find themselves shifting from the top to the bottom. And then it requires its departments to strive to adapt to these rapid and turbulent shifts and changes by bringing about a series of organizational and adaptive changes that are not limited to one organizational aspect only but rather include all organizational components. Accordingly, this research came to determine the readiness of public organizations to chan
... Show MoreThis research aims to learn about public relations programs and their role to enhance the morale of the State land Transport Company employees.The researcher relied on the survey method and use a questionnaire and scale tools to collect information from workers in the Department of Relations and Media and employees in all departments.
The research reached several conclusions, including:
1- Public relations seek to increase workers’ confidence in senior management and motivate them to improve their production, as well as their relentless endeavor to bring workers closer by following multiple and varied forms of communication with them.
2- The results of the study showed that there was a negative i
The current research aims to identify the level of impact of strategic improvisation as an independent variable on organizational health. The dependent variable in the Department of Health of Dhi Qar to reach appropriate mechanisms in order to reach appropriate mechanisms and recommendations proposed to contribute to the achievement of organizational health in the Department of Health of Dhi Qar (the research department) and based on the importance of the subject of research in government institutions and the important and service role of the Department of Health of Dhi Qar in the Iraqi society. The descriptive analytical approach was adopted in the completion of the research based on the opinions of the leaders in the surveyed depa
... Show MoreThe aim of this study was to evaluate the effects of local application of bisphosphonate gel and recombinant human bone morphogenic protein 2 gel, on titanium dental implant stability and marginal bone level. Twenty-seven patients with upper and lower missing posterior tooth/teeth were included in the study with a total of 71 implants that were used for rehabilitation. The implants were randomly divided into 4 groups: 3 study groups and 1 control. Group1; local application of bisphosphonate gel, group 2; local application of recombinant human bone morphogenic protein 2 gel, group 3; local application of a mixed formula of both gels. The gel application was immediately preimplant insertion, group 4; implant insertion without application of a
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