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.
A mathematical model has been introduced to investigate the effect of nuclear reaction constant ( A ), probability of the BEC ground state occupation Ω i, nD is the number density of deuteron (d) and the overall number of nuclei ND on the total nuclear d-d fusion rate (R). Under steady-state of the condensates of Bose-Einstein, the postulate of quantum theory and Bose-Einstein theory were applied to evaluate the total nuclear (d-d) fusion rate trapping in Nickel-metal The total nuclear fusion rate trapping predicts a strong relationship between astrophysical S-factor and masses of Nickel. The reaction rate trapping model was tested on three reaction d(d,p)T, d(d, n)3He and d(d, 4He)Q = 23.8MeV respectively. The reaction rate has described
... Show MoreBrainstorming is one of the fundamental and necessary concepts for practicing the auditing profession, as auditing standards encouraged the implementation of brainstorming sessions to reach reasonable assurance about the validity of the evidence and information obtained by the auditor to detect fraud, as the implementation of brainstorming sessions and the practice of professional suspicion during the audit process lead to increase the quality of auditing and thus raise the financial community's confidence in the auditing profession again after it was exposed to several crises that led to the financial community losing confidence in the auditing profession.
The research aims to explain the effect of brain
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Abstract
The study aims to identify the degree of citizenship values practiced by Bisha University students and identify the impact of gender, college, and academic level, on the degree of the practice of University students for citizenship values. The researcher used the descriptive-analytical method including a questionnaire of (44) items. To process the data, the researcher applied the computational averages, standard deviations, percentages, and T-test. The questionnaire was implemented on a sample of (600) of the 2 and 8 levels during the second semester of the academic year (2020-2019) at Bisha University. The study findings revealed that the degree of the pra
... Show MoreThe ligand 4-(2-aminmo-5-nitro-phenylazo)-1,5-dimethyl-2-phenyl-1,2-dihydro-pyrazol-3-one derived from 4-aminoantipyrine and 4-nitroaniline was synthesized. The synthesized ligand was characterized by 1HNMR, FT-IR, UV-Vis spectra and (C.H.N) analysis. Complexes of (YIII and LaIII ) with the ligand were prepared in aqueous ethanol with a 1:2 M:L ratio and at optimum pH. The prepared complexes were characterized by using flame atomic absorption, FT-IR, UV-Vis spectra,(C.H.N) analysis and conductivity measurement. The stoichiometry of complexes was studied by the mole ratio and job methods. A concentration range (1×10-4 - 3×10-4 M) obeyed Beer's law, the complex solutions show high values of molar absorption. On the basis of physicochemical
... Show MoreThis research shows the issues of Ibn Hisham's illusion in its leadership of the grammarians; As Ibn Hisham attributed - during his presentation of grammatical issues - grammatical opinions to a number of grammarians claiming them in them, and after referring to the main concepts that pertain to those grammarians, we found that Ibn Hisham had delusional in those allegations, in addition to that clarifying the terms illusion and claim in the two circles of language And the terminology, and perhaps the most prominent result in this research is that he worked to investigate these issues by referring to their original sources, with an explanation of the illusions of Ibn Hisham in his attribution to these issues.
The current study aimed to determine the relation between the lead levels in the blood traffic men and the nature of their traffic work in Baghdad governorate. Blood samples were collected from 10 traffic men and the age about from 20-39 year from Directorate of Traffic Al Rusafa/ Baghdad and 10 samples another control from traffic men too with age 30-49 year and they livedrelatively in the clear cities or contained of Very few traffic areas. The levels of lead in blood estimated by used Atomic Absorption Spectrometry.
The result stated that there is no rising of the levels of lead in blood of traffic men Lead concentration was with more a range from 14 ppm in Traffic police are not healthy They are within the permissible limits, Ap
The research problem is clearly deficient suffered by the internal audit function in all institutions of Iraq, as a result of the lack of sponsor organizations for this profession and there is no law or local legislation determine its powers and its responsibilities and scope of work As well as the lack of interest of senior management in economic units that function, as it focuses its work on the scope of financial and accounting matters only So required to rebuild this function in line with the current developments as well as the lack of a framework that defines the strategy of this function, and it came the idea of research to find out how to create a regulatory method for re-strategic construction of the internal audit function depen
... Show MoreThe research statement to the amount of the contribution of information and communication technology in the quality of tourism and hotel services, and determine the relationship between the impact of information and communication and the quality of tourism services technology, The importance of the research is to establish the philosophical thinking of the nature of variables, as a modern administrative terminology and employ them towards the quality of tourism and hotel services, the research dealt with a problem expressed by a number of intellectual and practical questions, Was formulated based on the current situation witnessed by the tourism sector and hotel in Iraq, and the real gap was the lack of awareness of the impo
... Show MoreThe research aimed to prepare a measure to evaluate the academic achievement of graduates working in the field of physical education from their point of view, to identify the extent to which graduating students benefit from the curriculum of the College of Physical Education and Sports Sciences, University of Baghdad/Al-Jadriya, and to identify the impact of academic subjects in the practical and theoretical fields. The researchers used the descriptive approach in the research procedures as it is an appropriate approach in achieving the research objectives. The following questions are: What are the academic subjects that have the most impact on graduating students? What are the academic subjects that have the least impact on the are
... Show MoreThis research aims to introduce the importance of electronic marketing and the extent of its impact on the quality of the insurance service in general, and the national insurance company in particular, and the advantages it can achieve, an increase in its competitiveness, as well as contributing to increasing the efficiency of the performance of the insurance company.
The research relied on the questionnaire form as a main tool for obtaining data and information by the 70 questionnaire questionnaires required for the field side of the research, as they were distributed and retrieved in full, and all of them are suitable for analysis. The sample .The questionnaire was designed with three axes, the first wa
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