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 research aims to identify the impact of managing performance's employees in building intellectual capital, Because employing the practice of managing the performance of employees may acquire familiar skills to improve their performance and reflect on the construction of intellectual capital in the surveyed area, Especially that the independent dimension represented by the management of the performance of employees is one of the important topics that has received attention in the world of management in general and human resource management in particular. While the adopted dimension was represented by Intellectual capital in the important practice of human resource management in the increasing of their knowledge, to
... Show MoreIn their cross-sectional study, Al-Rubaye et al studied the extent of vitamin D (VD) deficiency/ insufficiency, factors affecting its degree, and the adverse outcomes of the altered VD status among a group of mothers and their neonates from Baghdad, Iraq. They found that 96.6% of the mothers had VD deficiency/ insufficiency compared to 86.4% in their neonates. Maternal VD levels and neonatal weights were significantly correlated with neonatal VD levels. We believe that the study results need to be revised. This is based two points listed in this letter to editor
Abstract :
The research aims to Estimate the Strength of Strategic Innovation application in terms of application strength , and on the overall level in number of Iraqi Industrial business organizations . After wards determine whether their is differerences among those organizations in application process for the dimensions , and for the overall process .
The Research revealed number of conclusions including that the process of strategic innovation is applied in a good Level , and demonstrates the desier of the industrial companies Leaders to Launch beyond the familiar products , and to provide new products that
... Show Moreמטרת המחקר הזה היא לבדוק את שלושה סיפורים קצרים מהקובץ הראשון של אהרון אפלפלד , שנחשב ההצהרה הרשמית על היותו סופר השואה הראשון בישראל , המשותף לשלושת הסיפורים הוא הנימה של הגיבורים היוצאים למסע פיזי ונפשי לגלות את אשר אירע להם , מגמתו של המחקר היא לבדוק את הצורה המיוחדת שבה אפיין אפלפלד את גיבוריו שמעידים על כך , כי השואה היא החוויה המרה והקשה בקרב היהודים והשלכותיה נשארה טמונה בקרבם גם אחרי המלחמה ואחרי שנים
... Show MoreThe research aims to identify the role of the dimensions of financial inclusion in achieving the competitive advantage by An exploratory research of the views of a sample of customers of the 20 Algerian commercial banks, And the relationship between its dimensions (Access dimension, Usage dimension, Quality) And competitive advantage. This research is based on the analytical descriptive approach. The questionnaire was adopted as a main tool in collecting data and information on the sample of 377.
The The research showed several results, the most important of which is a strong correlation between the dimensions of the three financial inclusion combined and the competitive advantage of the Algerian commercial banks, and explained t
... Show MoreThe present study is concerned with studying the effect of aquatic plant Hydrella vorticellata with the concentration of 10 and 20 gm/2 K gm soil on percentage and growth rate of germinating seeds of Hordeum vulgare and Vicia faba. More overs, the quantitative amount of NPK in both tested plants and Hydrella vorticellata, are estimated as an organic fertilizer. It has also been find the total number of root cells, the number of dividing cells, and stages of mitosis. The study reveales, that there are no significant differences between the concentration of hydrella used in germination percentage, growth rate, wet and dry weight. While there are differences in the plants containing NPK. The number of cells dividing stages and number of divid
... Show MoreThe research aims to know the concept of politic behavior as one of the important behaviours in the different fields and sectors. It is considered to be part of the organizatial work to face the expected risks. It includes two group of factors personal (self –monitors, locus of control ,expectation s of success, perceived job alternatives)and organizational(promotion ,division resources,role ambiguity ,democratic decision)studied by the researcher in the frame of the relationship with the variable of display continuous trust matain which includes two variable (build trust mantain, display trust continuouness)through applied frame by random sample consists of (90)employee at Farouq State
... Show MorePraise be to God, Lord of the Worlds, and prayers and peace be upon the Master of Messengers and his family and companions.
The study of the jurisprudential opinions of scholars, their choices, or their weightings, sheds light on the approach they followed in their choices, and reveals the originality of the scholar or his influence on those who preceded him from among the scholars.
And the commentators of the noble hadith of the Prophet have their important contributions in this aspect, as they undertake the task of explaining the noble hadith, the second source of legislation
Contemporary commentators have their share in the service of the honorable hadith, and the statement of their choices and preferences, and am
... Show MoreThe topic of the research dealt with the image of Iraq in the British press based on a sample of the newspapers (The Guardian and the Daily Telegraph), which are among the most important and largest newspapers in the United Kingdom and the world, because of its active role in guiding local and international public opinion towards important issues and events, Since these two newspapers are interested in the accuracy of sensitive political topics, the message aimed at knowing the media image that these two newspapers painted about Iraq in the period that was limited to the first quarter of 2019, and also to know the nature of the contents promoted by these newspapers about the Iraqi reality, The method of content analysis was used as an ap
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The aim of the research to define the concept of moral intelligence and its dimensions and its relationship to some personal characteristics with the internal auditors and identify the importance of the employment of moral intelligence dimensions of (empathy, conscience, self- control, respect, kindness, tolerance, fairness) in the internal audit and the extent of support for the performance of the internal audit process in light of these dimensions. And that by answering the following question : Is there a role for moral intelligence of internal auditors in support the performance of internal audit process ? How are employ these dimensions i
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