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.
The current research aims to identify the " impact of strategic warheads numbered ( NHT) in the collection average second grade students in the article of history). " To achieve this, I assumed the researcher that there is no different between the statistically significant the average score for the collection of experimental group who teaches the Arab Islamic history on and a strategic warheads numbered and the average score for the collection of the control group who were studying the same article according to the classic method ( traditional) . The study sample consisted of 64 students from the second grade average in the secondary warka bin nawfal in the general Directorate for education first karkh in Baghdad for the annual cources 2
... Show MoreNew complexes of the type [ML2(H2O)2] ,[FeL2(H2O)Cl] and [VOL2] were M=Co(II),Ni(II) and Cu(II) ,L=4-(2-methyl-4-oxoquinazoline-3(4H)-yl) benzoic acid were synthesized and characterized by element analysis, magnetic susceptibility ,molar conductance ,FT-IR and UV-visible. The studies indicate that the L acts as doubly monodentate bridge for metal ions and form mononuclear complexes. The complexes are found to be octahedral except V(IV) complex is square pyrimde shape . The structural geometries of compounds were also suggested in gas phase by theoretical treatments, using Hyper chem-6 program for the molecular mechanics and semi-empirical calculations, addition heat of formation(?Hf ?) and binding energy (?Eb)for the free ligan
... 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
... Show MoreThis paper addresses the new coloring in the concept of dystopian society as represented by the positive role of one of the characters vs. the passive role of the government and its mutual effect on the people of the society. In addition, it describes how all men in the dystopian society victimize and degrade the other through unlawful acts, like: stealing, rape, and fear, which are the lowest points in a moral decay. However, it offers hope by illustrating a positive sense, as exemplified by the doctor's wife out of Saramago's optimistic view that men may be descended from good women. Accordingly, the paper aims to examine the effect of the government’s role in the lives of the people who have later turned into blind in a dystopian so
... Show MoreThis paper provides an attempt for modeling rate of penetration (ROP) for an Iraqi oil field with aid of mud logging data. Data of Umm Radhuma formation was selected for this modeling. These data include weight on bit, rotary speed, flow rate and mud density. A statistical approach was applied on these data for improving rate of penetration modeling. As result, an empirical linear ROP model has been developed with good fitness when compared with actual data. Also, a nonlinear regression analysis of different forms was attempted, and the results showed that the power model has good predicting capability with respect to other forms.
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 MoreIsocratic high performance liquid chromatography on reversed phase a (150x 4.6 mm I.D), 5 ?m ?-Bondapak RP-8 column (with acidic mobile phase allow the separation of doxcycycline hydrochloride with low detection limit of 0.2 µg/ml detected by UV set at 226 nm. The method was validated for Doxycycline between 0.156- to 5 µg/ml. The concentration of doxycycline was assessed in two single dose randomized crossover studies with intervals of one week between two period. In sera of 20 adults healthy male volunteers with average age of (42 + 10) year, body weight 48-85 kg, body height of (160-185cm) after a single dose of doxycycline hydrochoride 100 mg in form of capsules were orally administrated for both formulations. The blood sa
... 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 MoreThe importance of this research has been to rationalize the cost of producing maize seeds through the followers of modern techniques and methods in agricultural activities such as genetic engineering for the purpose of increasing production efficiency of maize seeds as well as the importance of calculating seed cost rationalization through the ABC system and thus rationalizing government spending. The research is based on a single hypothesis that the use of genetic engineering on corn seeds works to:increase production efficiency of seeds and savings in agricultural inputs, calculation of rationalization through the cost system on the basis of activity ABC The research reached a number of conclus
... Show MoreThis paper addresses the new coloring in the concept of dystopian society as represented by the positive role of one of the characters vs. the passive role of the government and its mutual effect on the people of the society. In addition, it describes how all men in the dystopian society victimize and degrade the other through unlawful acts, like: stealing, rape, and fear, which are the lowest points in a moral decay. However, it offers hope by illustrating a positive sense, as exemplified by the doctor's wife out of Saramago's optimistic view that men may be descended from good women. Accordingly, the paper aims to examine the effect of the government’s role in the lives of the people who have later turned into blind in a dystopi
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