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.
Objective: to evaluate the results of (Modification of Russe method) in treatment of nonunion fracture scaphoid bone by bone graft with external splintage (plaster of paris cast (pop ).
Methods:Prospective study done on 26 patients (24 male, 2 female), age range between 25-42 years (mean age 34 years), fracture site at middle 1/3 with minimal displacements with no carpal bone or radial bone injury, technique of Matte- Russe method (explore the bone through volar approach using bone graft from iliac crest (cortico-cancellous peg plus cancellus bone) with thumb spica for 90 days with period of follow up 12-18 months.
Results: out of 26 patients treated by this method , 23 patients (88.5%) union was achieved radiologically by the end
Freedom of opinion and expression occupy the first place among the concerns of countries and international organizations. And it is also the basis of contemporary freedom because it is the foundation for achieving freedom in other fields such as politics, economics, education, etc.. The constitutions of the state have ensured that almost the entire freedom to express an opinion in all its forms either orally or writing or images of expressions, but these freedoms are identified within the law. Most countries announced their commitment to the international conventions and texts issued by international and regional organization like the Universal Declaration of Human Rights in 1948, and the International Covenant on Civil and Political Rig
... Show MoreObjectives: study the relation between the effect of time (long time duration) with high concentration of iodine
and study its effect on the activity of the thyroid gland (hormonal and histological changes).
Methodology: An experimental study was done on (30) albino rats (8 weeks of age) to know the effect of high
concentration of iodine on the activity of the thyroid gland (hormonal and histological changes) related with
time. The study last for six months for the period of 1/2/2007 to 31/7/2007, the experiment was carried out in the
research lab. of pathology department, College of Medicine, University of Baghdad.
Results: The study shows changes in hormonal levels of thyroid hormones (T3 & T4) and also histologic
The aim of the research is to demonstrate the importance of leadership empowerment in its dimensions (knowledge, participation in decision-making, incentives, trust between the leader and subordinate, delegation of authority and communication) and its impact on enhancing the effectiveness of the company in its dimensions Represented by (achievement of objectives, quality of insurance service, adaptation to work environment and job satisfaction), by adopting the questionnaire as a main tool in collecting data from officials in the National Insurance Company, numbering (56) surveyed in job sites (section manager, division official and unit official) Their answers were analyzed using the SPSS statistical program in calculating the a
... Show MoreOne of the most frightening to children ages pre-school entry , Are those concerns about natural phenomena such as (The darkness, the sound of thunder, lightning and light, and rainfall, and storms) These natural phenomena are not familiar to the child , It may have a surprise when he/ she sees , And others intimidated , The affects of panic and fears that may lead him some psychological injury symptoms.
The fear of the dark, of the most common concerns associated with the child in his daily life , As the children's fear of the dark is reasonably fear that makes him a natural to live in the unknown , We can not identify what around him and is afraid of something collision, Or injury from somet
... Show MoreThe research problem lies in identifying the challenges facing spreading the culture of peace in Iraq, and the most important factors of its instability from the point of view of leaders and intellectual elites.The research derives its importance from the fact that the peace imposed by justice leads to a stable Iraq and a prosperous future.
The study aims to identify the most prominent challenges and obstacles created by wars and faced the process of spreading the culture of peace and instability in Iraq, and to shed light on the reasons leading to the employment of the capabilities of community leaders in spreading the culture of peace.The objective of the current research is to identify the challenges of spreading the culture o
... Show MoreThe research aimed to prepare a measure of job stressors affecting the quality of teaching performance in the College of Physical Education and Sports Sciences at the University of Baghdad, to identify their levels, if any, and the most influential dimensions on the quality of teaching performance within the college’s work environment, as well as the deanship’s ability to help prevent and Alleviating its severity through logical administrative methods, on a scale that includes four dimensions that include (the administrative and financial environment, the organizational environment, the social and humanitarian environment, and the scientific and research environment). The descriptive approach was adopted using the case study met
... Show MoreBackground: Diabetes is defined by the World Health Organization as a metabolic disorder characterized by chronic hyperglycemia with disturbances of carbohydrate, fat and protein metabolism resulting from defects in insulin secretion, insulin action, or both. Families are co-regulating systems in which the stresses and strains of one family member affect the well-being of another member of the family. Caregivers of children with chronic illness report experiencing more parental stress than parents of healthy children.
Objective: A descriptive cross-sectional study had been conducted in four centers of endocrine diseases in Baghdad city and data was collected by using self-administered questionnaire regarding qua
... Show MoreThis study deals with the absence of state control over the whole of the Syrian geography in creating an environment conducive to the emergence of a new force represented by armed groups and organizations that point to fundamental changes in the conflict and to transform competition for control over the land into a struggle for influence. Which in itself represents the prospects of change in the Syrian scene, and that understanding their interests requires shedding light on the extent of the continuation of this competition and the conflict on land and expansion at the expense of the other, and thus contribute to complicate the Syrian scene, especially after attempts to bite Of land and annexation to each party's areas of influence, espe
... Show MoreIn this paper, we consider the problem of stochastic project network when some or all activities are interrupted. An approach has been built to schedule the critical activities, by constructing some expressions based on the project lateness costs due to the interruption activities. Two simple example are presented to validate our approach.
Key words: Project Management, Project scheduling, Stochastic activity duration, Stochastic PERT.
Introduction
Recently, Projects planning and optimal timing, under uncertainty are extremely critical for many organizations, see [19]. Having an effective mathematical model wi
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