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 current research aims to shed light on the Global Reporting Initiative (GRI), which helps to report financial and non-financial information by economic units in general and listed on the Iraq Stock Exchange in particular. The research was based on a main premise that apply the criteria of the Global Reporting Initiative (GRI) would provide useful information to users to help them make appropriate decisions. To achieve the goal of the research, the descriptive analysis method was used, and quantitative analysis was used. At the level of the descriptive analysis method, a desk survey was conducted. As for the quantitative analysis, it relied on applied data through a questionnaire form (Questioners) as a research tool, and the
... Show MoreThe electron correlation effect for inter-shell have been analysed in terms of Fermi hole and partial Fermi hole for Li-atom in the excited states (1s2 3p) and (1s2 3d) using Hartree-Fock approximation (HF). Fermi hole Δf(r12) and partial Fermi hole Δg(r12 ,r1) were determined in position space. Each plot of the physical properties in this work is normalized to unity. The calculation was performed using Mathcad 14 program.
The research aims to study the reliability of government institutions, including the audit directors, which are one of the most important oversight formations in the Ministry of Construction, Housing and Public Municipalities, on which the responsibility for comprehensive auditing of all the Ministry's (municipalities) formations falls on the Managing the Audit Program according to the specification (ISO 19011: 2018) to improve the audit performance which requires compliance with the application of the audit management system in accordance with the standard Specification (ISO 19011: 2018), depending on the methodology of the case study, and using of checklists, which were chosen ac
... Show MoreBackground: Tap waters play an important role in fulfilling the people needs for drinking and domestic purposes. Contaminate the tap water with different pollutants has become an issue of great concern for 90% of people who are depended on the tap water as the main source of drinking. Pollutants can make their way easily into the delivering pipes which suffer from the leaking resulting in decreasing the quality of water. Objective: Therefore, assess the water quality for drinking purpose by calculating the water quality index is an important tool to ascertain whether the water is suitable for human consumption or not. Methods: In the present work, the water quality of the Al-Salam, western region of Baghdad city, Iraq was investigated for 7
... Show MoreThe Accounting Disclosure for non-current intangible assets is necessary to rely on accounting information by decision makers in the economic unity, two international accounting standards issued (IAS16,36), which aims to provide the foundations of the recognition, measurement and disclosure of appropriate assets Non-current tangible. (IAS16) allowed to use re-evaluation approach to measure assets entrance due to the inadequacy of the accounting information resulting from the application of the historical cost of the entrance under increasing technical developments and continuing that leave clear their effects on non-current intangible assets, As well as the requirements of what came (IAS36) the importance of accounting for the impairment
... Show MoreAdontomerus amygdali (Boucek, 1958) (Hymenoptera, Torymidae) is recorded for the first time in Iraq, parasitizing almond fruits wasp, Eurytoma amygdali Enderlein, 1907 (Hymenoptera, Eurytomidae) infesting fruits of almond trees Prunus dulcis (Mill.) D. A. Webb (=Amygdalus communis Linn.) growing in Koysinjaq district, Erbil, Iraq. A short morphological description of this species is presented.
The aim of this study to identify patterns of cerebral control (right and left) for second grade students in the collage of physical education and sports science of the University of Baghdad, as well as identify the definition of theThe Effect of Using the Bybee Strategy(5ES) according to Brain Control Patterns in Learning a Kinetic Series on Floor exercises in Artistic Gymnastics for menمجلة الرياضة المعاصرةالمجلد 19 العدد 1 عام 2020effect using the (Bybee) strategy (5ES) according to brain control patterns inlearning a Kinetic series on floor exercises In artistic gymnastics for men, andidentify the best combination between the four research groups learn, use Finderexperimental method research sample consi
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