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.
This study focuses on studying the effect of reinforced steel in detail, and steel reinforcement (tensile ratio, compression ratio, size, and joint angle shape) on the strength of reinforced concrete (compressive strength) Fc' and searching for the most accurate details of concrete divisions, their behavior, and corner resistance of reinforced concrete joint. The comparison of this paper with previous studies, especially in the studied properties. The conclusions of the chapter are summarized that these effects had a clear effect and a specific effect on the behavior and resistance of the reinforced concrete corner joints under the negative moments and under their influence and the resulting stress conditions. The types of defects that can
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Abstract has many advantages as has historically been one of the regions leading cultural centers . for centuries , it has been a center of commertial and financial operations in Iraq. it is also rich in archeological sites and natural resources, but because of its wars and implementation of urban development strategies are effective and sustainable , so contracted the secretariat of Baghdad with the company (khatib and scirntiffic) for the preparation of the comprehensive development plan for the city of Baghdad in 2030 and funded by the world bank and the fact that the plan was approved ( three stages of it ) and only one phase remains the fourth stage, which is under discussion the aim of the
... Show MoreThe added value of internal audit greatly contributes to adding value to the institution, but most departments of economic units in Iraq neglected the role of internal audit and the added value that can be achieved by those institutions, since the term added value of internal audit is a relatively vague term from the premise that what cannot be measured is difficult Determine it, and perhaps descriptive standards for it is the extent of compliance with international auditing standards (IIA).
The research aims to study the procedures and results of auditing to verify that they have given an added value to the audit with a positive impact, develop its aspects and research, identify deficiencies for the audi
... Show MoreThe orbital motion and longitude for some Jupiter's satellites (Amaletha, Europa, Ganymede and Callisto) were calculated from two different locations Iraq and Syria. A program was designed, the input parameters were the desired year, month, day and the longitude of the location, the output parameters results were applied in form of a file, and this file includes the longitude, orbital motion, and local time of these satellites. A specific date 1-10-2013 was taken, the results of longitude was (20-336) º and orbital motion was (92-331) º for both Iraq and Syria location with observing time (05:24:14-15:18:10) for Iraq and (04:56:33-14:50:30) for Syria. The difference in time between the two locations was constant (00:45:00), these results
... Show MoreThis study is due to insufficient development of the issues of initial training in tennis at youthful (student) age. Objective: development of a methodological and scientific-methodological base of students' tennis with current trends in tennis. Summing up the best practices of modern tennis, we came to the conclusion that the formation of the art of reflection backhands in teaching beginner students of sports specialization to achieve future success. In modern conditions in the development of Russian tennis student opens the possibility of using new technologies and programs. Using these approaches, we have developed a training program and tested students' tennis in the pedagogical experiment, which resulted in its effectiveness.
The researcher attempts to examine Barman model in acquiring the historical concepts among fourth-grade students at literary classrooms. To this end, the researcher held the null hypothesis, there is no significant difference between the experimental groups who was taught based on Barman model and the control group that taught based on the traditional method in acquiring the historical concepts on the post-test. To testify the effectiveness of Barman model, the researcher administered a questionnaire included (60) items on bunch of female-students who were selected from al-khamaeal preparatory school in al-hurriyah district in Baghdad. The author utilized different statistical tools to analyze the collected data. &
... Show MoreThe risk assessment for three pipelines belonging to the Basra Oil Company (X1, X2, X3), to develop an appropriate risk mitigation plan for each pipeline to address all high risks. Corrosion risks were assessed using a 5 * 5 matrix. Now, the risk assessment for X1 showed that the POF for internal corrosion is 5, which means that its risk is high due to salinity and the presence of CO, H2S and POF for external corrosion is 1 less than the corrosion, while for Flowline X2 the probability of internal corrosion is 4 and external is 4 because there is no Cathodic protection applied due to CO2, H2S and Flowline X3 have 8 leaks due to internal corrosion so the hazard rating was very high 5 and could be due to salinity, CO2, fluid flow rate
... Show MoreIn this paper we prove the boundedness of the solutions and their derivatives of the second order ordinary differential equation x ?+f(x) x ?+g(x)=u(t), under certain conditions on f,g and u. Our results are generalization of those given in [1].
The financial analysis of the published financial statements is the means that enables businessmen, financial institutions, financial analysts and others to conduct their studies and conclusions to obtain information that helps them in the decision-making process, including decisions related to investment. National in making the decision on the investment activity, for the period from 2012 to 2018, through the information provided by the annual financial statements, by selecting a set of indicators provided by the financial statements, namely (liquidity ratio, activity percentage, profitability ratios) to measure the extent of this ability Indicators in determining their role in making an investment decision.
The purpose of the research is to present a proposed accounting system model for converting and aggregating accounting information within the framework of the differentiated accounting systems, and the research methodology consists of: The research problem is the existence of differentiated and dispersed accounting systems that operate within governmental economic units and at the same time seek to achieve a unified vision and goals for the organization, and the central research hypothesis is the possibility of conducting the process of conversion accounting information from the government accounting system to the unified accounting system, and then aggregate those systems. The research was conducted at the College of Administrat
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