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.
General Directorate of Surveying is considered one of the most important sources of maps in Iraq. It produced digital maps for whole Iraq in the last six years. These maps are produced from different data sources with unknown accuracy; therefore, the quality of these maps needs to be assessed. The main aim of this study is to evaluate the positional accuracy of digital maps that produced from General Directorate of Surveying. Two different study areas were selected: AL-Rusafa and AL-Karkh in Baghdad / Iraq with an area of 172.826 and 135.106 square kilometers, respectively. Different statistical analyses were conducted to calculate the elements of positional accuracy assessment (mean µ, root mean square error RMSE, mini
... Show MoreDyspepsia is a significant public health issue that affects the entire world population. In this work, we formulate and analyze a deterministic model for the population dynamics of Gut bacteria in the presence of antibiotics and Probiotic supplements. All the possible equilibria and their local stability are obtained. The global stability around the positive equilibrium point is established. Numerical simulations back up our analytical findings and show the temporal dynamics of gut microorganisms.
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The concept of self is considered one of the important dimensions in the human personality, because feeling of self is an important characteristic in this phase from the psychological point of view.
The first source which forms the concept of self is the physical image, where the built and appearance of the body is considered among the vital matters which determine the person's image of himself/herself.
The current research aims to:
1) Identify the level of physical self concept at the kindergarten children.
2) Identify the level of psychological self concept at the kindergarten children.
3) Iden
... Show MoreThe current research aims to measure the job satisfaction of educational counselors in the general directorate of education of the second Rusafa in the ministry of education of Iraq. Moreover, it aims to identify the significant differences in job satisfaction according to the gender (Male-Female), the length of service (less than 15 years more than 15 years), and the relationship between these two variables. To achieve the objectives of the research, the researcher developed a scale to measure job satisfaction. This tool was applied to sample of (100) educational counselors selected randomly. The results showed that educational counselors have job satisfaction, in which males are more satisfied in their job than females. The results als
... Show MoreThe most important topics that constitute the aesthetic and substantive aspect of the theatrical performance represented by the spatial environment of the presentation and the proposed virtual place that contains the technical and artistic elements of the presentation and highlights the strength of influence on it. In light of the above, the researchers divided the topic into four chapters.
The first chapter contained (the methodological framework), which included the research problem with regard to the directing treatments between the directors in establishing or creating theatrical venue, the importance of the research and the aim of the research, and the limits of the research to conclude the chapter by defining the terms.
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Since her early beginning in 1974 in her novel "Les armoires vides", Annie Ernaux writing about life in all its various aspects remained her main goal. This novel gave the earliest signals of what would happen later on in her literary career. Indeed, her works showed abilities of echoing reality, her sufferance and experiences via the use of simple and clear language. Add to this, her writings are to be viewed as an expression of deep felt journey, and a continuous search due to the consequent changes coming out of her identity.
We try here to give an answer to the question about writing as to whether being, to Ernaux herself, a need for the search about her social and feminist identity, or a pure literary work
... Show MoreThe city of Karbala is one of the most important holy places for visitors and pilgrims from the Islamic faith, especially through the Arabian visit, when crowds of millions gather to commemorate the martyrdom of Imam Hussein. Offering services and medical treatments during this time is very important, especially when the crowds head to their destination (the holy shrine of Imam Hussein (a.s)). In recent years, the Arba'in visit has witnessed an obvious growth in the number of participants. The biggest challenge is the health risks, and the preventive measures for both organizers and visitors. Researchers identified various challenges and factors to facilitating the Arba'in visit. The purpose of this research is to deal with the religious an
... Show Moreالمستخلص يهدف هذا البحث الى تجاوز مشكلة البعدية من خلال طرائق الانحدار اللامعلمي والتي تعمل على تقليل جذر متوسط الخطأ التربيعي (RMSE) , أذ تم استعمال طريقة انحدار الاسقاطات المتلاحقة (PPR) ,والتي تعتبر احدى طرائق اختزال الابعاد التي تعمل على تجاوز مشكلة البعدية (curse of dimensionality) , وان طريقة (PPR) من التقنيات الاحصائية التي تهتم بأيجاد الاسقاطات الاكثر أهمية في البيانات المتعددة الابعاد , ومع ايجاد كل اسقاط
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New membrane electrodes for determination of ciprofloxacin hydrochloride were prepared depending on ciprofloxacin hydrochloride - phosphotungstic acid (CFH-PT) as an active material and these electrodes were made with three plasticizers: Di-octylphenylphosphonate(DOPH), Di-butyl phosphate (DBP)Tri-n-butyl phosphate(TBP), in PVC matrix. One of the ciprofloxacin electrodes was gave Nernstian slope equal to 57.21 mV/ decade for DOPH membrane with concentration range from 1.5×10-5 to1.0×10-1 M, and detection limit equal to 1.5×10-6 M .Lifetime was 93 days. Non- Nernstian responses equal to 39.40 and 30.70 mV/ decade for membranes DBP, TBP, respectively. These electrodes were gave concentration range from 1.0× 10-5 to 1.0×10-2 and from 4.0
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The objective that the researcher seeks to achieve through this research is to clarify the relationship between strategic management accounting techniques and the reliability of financial statements, and to measure the impact of these techniques as an independent variable with its three dimensions, which are: activities-based cost, target cost, and benchmarking on the reliability of financial statements as a dependent variable. To achieve this objective, the researcher did the following: First: Determine the research problem through the following question: Do strategic management accounting techniques affect the reliability of financial statements in industrial companies listed on the Palestine Exchange? Second: Making the analytical des
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