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.
Abstract:
The aim of this research is to highlight the importance of achieving customer satisfaction by using information technology and Internet networks in the process of purchasing flight tickets, and switching from the traditional method of purchasing and payment operations to the electronic method, to reduce the financial and non-financial risks associated with the traditional purchasing process, as well as saving time, effort and costs for the customer. The researcher used the deductive approach in linking the variables (achieving customer satisfaction and Internet of Things technology for booking electronic tickets)
... Show MoreSlag of aluminum is a residue which results during the melting process of primary and secondary aluminum production. Salt slag of aluminum is hazardous solid waste according to the European Catalogue for Hazardous Wastes. Hence, recovery of aluminum not only saves the environment, but also has advantages of financial and economic returns. In this research, aluminum was recovered and purified from the industrial wastes generated as waste from both of State Company for Electrical and Electronic Industries (Baghdad/AlWaziriya) and General Company for Mechanical Industries (Babylon/-Al-Escandria). It was found that these wastes contain tiny proportions of other elements such as iron, copper, nickel, titanium, lead, and potassium. Wastes were
... Show MoreA field study aimed at identifying the reality of the application of strategic management in the colleges of education/ University of Baghdad. The research adopted the descriptive analytical approach. The research community, consisting of 801 faculty teachers, has been identified. The research sample was selected in a simple random way and represented 15% of the research community, totalling 124 teaching members. A questionnaire was constructed that included (46) items divided between areas (strategic objectives, strategy planning and formulation, implementation of the strategy, and evaluation of the strategy). The honesty and consistency of the tool was verified. The researcher analyzed the research data using SPSS. The most important resu
... Show MoreThe study attempts to identify 1) the habits of playing video games among students, 2) the effect of playing video games on students’ academic achievement, 3) the statistically significant differences among students in regard of (gender, time of playing video games, number of hours). To this end, a five-likert scale questionnaire included four questions was applied to (250) male and female students chosen randomly from the second-intermediate stage at Al-Karakh side secondary schools. The findings revealed that students play games only on holidays and less than an hour daily, which means playing games does not affect their academic achievement. Additionally, the findings found there is a significant difference between male and female i
... Show MoreThe researcher aims to detect the emotive equanimity in kindergartens teachers,also to uncover the anxiousness in children of kindergartens,then to detect the relationship between them,then to choose the simple random way which is about(180) teachers and children,when the twore searchers made two tools to measure the emotive equanimity and the anxiety for both teachers and children,statistical methods had been used include:(pearsons correlation coefficient,t-test for one sample,t-test for two independent samples are individuals).the researcher led to multiple results:
1-the teacher has an emotive equanimity.
2-children has no anxiousness.
The research is Concerned the Relationship between Self Management which is a modern administrative term and its dimensions "Self Control, Trust, and Conscientiousness" with the Hardiness and its dimensions "Challenge, Commitment, and Control". And the impact of the first variable on the second in The Hospital of Alshaheed Gaze Alharery.
The Questionnaire used and distributed on sample (60) Persons, contain from (40) Doctor, and (20) Employees from the total society (103).
The statistical methods have been used for testing the hypothesis is the mean, standard deviation correlation coefficient.
The resea
... Show MoreThe issue of dignity is one of the topics that do not pass as long as the earths and the heavens remain; Because the earth is not devoid of the righteous, the believers, the saints, and the pious, and these do not cease from them aid, dignity, insight, or good vision, and from here the authorship in this section was continuous; Because the people’s need for it is confirmed as time progresses, and in that, Ibn Taymiyyah says in the sum of his fatwas, “And from what it should be known is that dignities may be according to the man’s need, so if the weak needs them Faith or the needy, he is given from it what strengthens his faith and fulfills his needs, and he who is more complete is the guardianship of God than him. He is independent
... Show MoreNear-ideal p-CdS/n-Si heterojunction band edge lineup has been investigated for the first time with aid of I-V and C-V measurements. The heterojunction was manufactured by deposition of CdS films prepared by chemical spray pyrolysis technique (CSP) on monocrystalline n-type silicon. The experimental data of the conduction band offset Ec and valence band offset Ec were compared with theoretical values. The band offset Ec=530meV and Ev=770meV obtained at 300K. The energy band diagram of p-CdS/n-Si HJ was constructed. C-V measurements depict that the junction was an abrupt type and the built-in voltage was determined from C-2-V plot
These deposits take many forms like current acc, deposits in order to growth and serve national economy Various in varicose perspectives .
The problem of this paper its concern with un applied the mathematical models that used in profitability analysis of current acc , and deposits in view of risk, profit efficiency and financial leverage for this reason the paper discussion use the cumulate mathematical model to solve these problem, that content three variables that be used to measuring profitability by consequent replacement method by stable base and by moving base for 2007 – 2009 applied the data collect from Iraq middle east bank. &nbs
... Show MoreThat achieve a level of excellence for the quality of university education cannot be achieved only by uniting the efforts of all employees at the university and active participation by students and by alumni and the labor market and society, however we can say that the administrative and academic university staff play an active role and the largest in achieving equivalent quality of higher education, It should unite the efforts of all employees in the educational institution in order to achieve quality education. It is the concept of quality of education, quality assurance and overall management of the quality of the basic pillars on which it is based university education. That highlight the need fo
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