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 diagnose the role of social responsibility as a contributing factor in enhancing the quality of services provided by the public sector in Iraq, where the research sought to demonstrate the relationship and impact of social responsibility dimensions (economic, legal, moral, and human) on the sector Services related to the electric field in Nineveh governorate because of its importance and its direct relationship with the citizen especially after the end of military operations in the destruction of the electricity sector by a large percentage in the city of Mosul. Nineveh Electricity Distribution Directorate / Center was chosen as a research community including (administrators and staff) of the research
... Show MoreGas and downhole water sink assisted gravity drainage (GDWS-AGD) is a promising gas-based enhanced oil recovery (EOR) process applicable for reservoirs associated with infinite aquifers. However, it can be costly to implement because it typically involves the drilling of multiple vertical gas-injection wells. The drilling and well-completion costs can be substantially reduced by using additional completions for gas injection in the oil production wells through the annulus positioned at the top of the reservoir. Multi-completion-GDWS-AGD (MC-GDWS-AGD) can be configured to include separate completions for gas injection, oil, and water production in individual wells. This study simulates
Abstract Diabetic nephropathy (DN) is a prevalent chronic microvascular diabetic complication. As inflammation plays a vital role in the development and progress of DN the macrophages migration inhibitory factor (MIF), a proinflammatory multifunctional cytokine approved to play a critical function in inflammatory responses in various pathologic situations like DN. This study aimed To assess serum levels of MIF in a sample of Iraqi diabetic patients with nephropathy supporting its validity as a marker for predicting nephropathy in T2DM patients. In addition, to evaluate the nephroprotective effect of angiotensin-converting enzyme (ACE) inhibitors in terms of their influence on MIF levels. This is a case-control study involving ninety
... Show MoreThis study aims at identifying the role played by Public Relations in the field of security awareness of the dangers of terrorism. The research is directed to the employees at the Directorate General of Public Relations and Media at the Ministry of Interior. And that on the basis that those who play an important role in the security awareness are the security institutions, primarily the Ministry of Interior, since this Directorate is responsible for all subjects related to the public security using public relations science. It aims at identifying the functions, methods and communication tools used by the Directorate to raise awareness about the dangers of terrorism. In order to achieve the research objectives, the researcher uses the sur
... Show MoreThis research aims to analyze the intellectual and civilizational regression that afflicted Iraqi and Arab society due to political and religious tyranny and internal conflicts, which was reflected in the deterioration of human rights values and the absence of equality and justice in dealing with the other religiously, which affected the reluctance of members of religious groups to interact with their national societies and then migrate to Outside, which contributed to a double loss, in terms of the loss of these societies by productive and effective national competencies, and in terms of distorting the image of Islam. The research stressed that the first treatments of this phenomenon are the consolidation of the values of citize
... Show MoreThis paper deals with social responsibility visible to the media and the role they play in spreading the culture of environmental protection, and make research on a sample of the University of Baghdad consisting students from 150 students, male and female were distributed questionnaire form on the sample to obtain the required information has been questionnaire included axes distributed questions achieve the objectives of the search, and after the form data were analyzed using statistical program spss results show that the visual media and its role in spreading the culture of environmental protection form averages arithmetic high, indicating a rise in the influence of th
... Show MoreAddressed this research the impact of intelligence emotional dimensions of the main(self awareness, and self-management, and social awareness, and relationship management) in the performance excellence the university(performance optimization, and strategic development) this is by middling the styles decision making which are (rational and intuitive, and dependent, and spontaneous, and avoidant), and Go search of an intellectual dilemma raise fundamental questions revolve around the search was to answer those questions through a theoretical framework for search variables first and test models of the relationship and second through the impact six hypotheses President.The objective of the research to make sure the contr
... Show MoreExpected to The organizational commitment by employees increases their loyalty towards their organization and thus contribute to enhancing their performance , therefore this study aimed to discover the relationship and the impact between the organizational commitment (emotional commitment, standard commitment, continuous commitment) and the performance of employees in the company researched, additional to know the available organizational commitment levels of employees in the company researched and its impact on the performance of employees, Research was conducted at the General Company for products in the dairy to achieve the goals of research has been developed questionnaire conation (22 ) items to collect data from the study s
... Show MoreThis research aims to study the influence of organizational power on the achievement of entrepreneurship for business organizations. It is an analytical study of the views of a sample of managers in the Iraqi Ministry of Education. The research highlights the contribution that can be made from the knowledge of the theory of business organizations in achieving organizational success. The organizational power of the organization contributes to achieving entrepreneurship in the business environment and achieving a competitive position in the work environment. The research dealt with two variables: the first is the independent variable, the organizational power in its dimensions (Expend Power, Structural Power, Prestige Power). And t
... Show MoreThe study aims at diagnosing the importance of environmental analysis (external, industrial and internal) in the organization's strategy for the development of public organizations. The theoretical problem derived from the existence of a knowledge gap for studies and research that dealt with the variables of the study. Three public organizations were selected as the study society (the Civil Defense Directorate, the Directorate of Nationality, Passports and Residency, the General Traffic Directorate). The sample of the study was a sample of (215) managers (managers, department managers, Analysis of the data and hypothesis testing using the appropriate statistical tools, Pearson, the simple and multiple regression coefficient to te
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