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.
Academic writing is a key skill for success in academic life, particularly for graduate students of a foreign language. The importance of writing to academic culture, practice, and knowledge building has led to a great deal of research in many fields, including rhetoric and composition, linguistics, applied linguistics, and English for Academic Purposes (EAP). Often, studies and research investigating academic writing are motivated by the need to inform the learning of writing to native and non-native English-speaking students, through both descriptions of professional academic writing as well as through comparisons of novice writer (native and non-native Englishspeaking) and expert production. However, while learning about academic writing
... Show MoreBackground: Orthodontic mini-implants are increasingly used in orthodontics and the bone density is a very important factor in stabilization and success of mini-implant. The aim of this study was to observe the relationship among maximum bite force (MBF); body mass index (BMI); face width, height and type; and bone density in an attempt to predict bone density from these variables to eliminate the need for CT scan which have a highly hazard on patient. Materials and Methods: Computed tomographic (CT) images were obtained for 70 patients (24 males and 46 females) with age range 18-30 years. The maxillary and mandibular buccal cortical and cancellous bone densities were measured between 2nd premolar and 1st molar at two levels from the alveol
... Show MoreMishrif Formation is the main reservoir in oil-fields (North Rumaila, South Rumaila, Majnoon, Zubair and West Qurna) which located at Basrah southern Iraq. The Inductively coupled plasma-Mass spectrometer (ICP-MS) was used for the water chemistry analysis and Scanning Electron Microprobe (SEM) for the purpose of mineralogy diagnosis. A weak acidic water of salinity six-time greater than seawater plays a role in generating the formation pressure and controlling the fluid flow. The potentiometric subsurface maps were modeled and the direction of super-pressure sites that are of a great importance in the oil exploration were marked to pay attention during future drilling.
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The aim of this research is to demonstrate the nature of the interactive relationship between the dimensions of the requirements of economic intelligence Represented by(Administrative and regulatory requirements, human requirements, and technical requirements) The strategic success of banks is represented by (Customer satisfaction, customer confidence, quality of service, growth) In three of the Iraqi banks own bank(Middle East Iraqi Investment, Al Ahli Iraqi, Gulf Commercial), The questionnaire was adopted as a tool for collecting data and information Of the sample (85) Who are they(Director of the Commissioner, M. Director Plenipotentiary, Director of Department, Director of Section, M. Section Manager, Division Officer, Unit Officer),
... Show MoreThe research synthesis variables of competitive advantage and the mechanism achieved by focusing on knowledge abilities and strategic of the administrative leadership, and governments and the developed countries took the racing frantically and my destiny to invest more money and resources to development of wealth and human knowledge is so choice investment winner always and who Aaikhyee never, because God Almighty give humans the abilities of all other creatures and that these abilities varying from person to person, there is the problem of search provoking questions about the essence of what it's about research and both sides theoretical and field, the objective of this research
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Abstract
The aim of the current research is to prepare an integrated learning program based on mathematics standards for the next generation of the NYS and to investigate its impact on the development of the teaching performance of middle school mathematics teachers and the future thinking skills of their students. To achieve the objectives of the research, the researcher prepared a list of mathematics standards for the next generation, which were derived from a list of standards. He also prepared a list of the teaching competencies required for middle school mathematics teachers in light of the list of standards, as well as clarified the foundations of the training program and its objectives and the mathematical
... Show MoreBackground: While two-thirds of breast cancers express hormone receptors for either estrogen (ER) and/or progesterone (PR) , genetically altered PI3K pathway was found in more than 70% of ER-positive breast cancers.An aberrant activity of cyclin-dependent kinase 1 (CDK1) in a wide variety of human cancers has selectively constituted an attractive pharmacological targets in MYC-dependent human breast cancer cells.
Aim of the study: Role of p110-beta as well as and CDK 1 in the pathogenesis of subset of breast cancers and contribution in their carcinogenesis.
Type of the study: is a retrospective study
Methods: This retr
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Job stress is considered one of the most important obstacles that may appear in the work field. In order to deal with the obstacles and challenges , the idea to deal with job stress has come to address job stress as one of the most important trends that enable organizations to face those challenges through focusing on the role of job stress and the organizational climate of the organization.
The research deals with two variables: the job stress as an independent variable, and the organizational climate as a dependent one. Each variable includes five sub-dimensions. These dimensions have been involved in an interaction to form
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The competition in the hotel sector, globalization and the development of new information have forced the sector to continuously seek new techniques and arrangements to remain competitive through hotel industry companies, including Benchmarking and the application of this method in the hotel sector. The selection of the Rashid International Hotel by the Ministry of Tourism as a leading hotel or benchmark for comparison of other hotels in Iraq, and the selection of two hotels in Baghdad for comparison, namely (Ishtar International Hotel, Baghdad International Hotel) and the choice also by the Ministry of Tourism, N is to correct the course of practice to manage the cost and diagnosis of the weakness of the strengths and weaknesses in the
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