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.
Abstract
The aim of this study was to identify the impact of the Knowledge Management Processes on organizational creativity in the Airlines Companies working in Sudan. The hypotheses formulated as:, there is a positive relationship statistically significant differences between knowledge management processes (diagnosis, the acquisition, storage, distribution and application) and organizational creativity. the measurement of the variables had been adopted from previous studies. The study used a Descriptive approach and and the analytical statistical method to construct the model and SPSS Program for data analysis .Purposive sample procedure had been chosen and structured questionnaire had been developed. Out of 215 q
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This research aim to overcome the problem of dimensionality by using the methods of non-linear regression, which reduces the root of the average square error (RMSE), and is called the method of projection pursuit regression (PPR), which is one of the methods for reducing dimensions that work to overcome the problem of dimensionality (curse of dimensionality), The (PPR) method is a statistical technique that deals with finding the most important projections in multi-dimensional data , and With each finding projection , the data is reduced by linear compounds overall the projection. The process repeated to produce good projections until the best projections are obtained. The main idea of the PPR is to model
... Show More- baumannii is an aerobic gram negative coccobacilli, it is considered multidrug resistance pathogen (MDR) and causes several infections that are difficult to treat. This study is aims to employ physical methods in sterilization and inactivation of A. baumannii, as an alternative way to reduce the using of drugs and antibiotics.
Cold Atmospheric Plasma was generated by one electrode at 20KV, 4 power supply and distance between electrode and sample was fixed on 1mm. A. baumannii (ATCC 19704 and HHR1) were exposed to Dielectric Barrier Discharge type of Cold Atmospheric Plasma (DBD-CAP) for several periods
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
... Show MoreThe current study aims to demonstrate the role of strategic renewal in enhancing organizational immunity through strategic renewal mechanisms represented by (Reanimating, Rejuvenation, Venturing, and restructuring). The main idea of this study relates to the extent to which organizations’ immunity is achieved through strategic Renewal mechanisms, by measuring these dimensions with Organizational immunity represented by organizational learning, organizational memory, and organizational DNA. The study population was the headquarters of the Iraqi Ministry of Education, and the sample included (330) individuals from the upper, middle, and lower leadership levels. Several statistical methods were used to deal with the results of the questionna
... Show Morethis research seeks to shed light on the study of the impact of Putinism on the Russian-Ukrainian war that broke out in early 2022, by studying the contents of the speeches of Russian President Vladimir Putin before the start of the war. This research uses the structural approach in analyzing the components of the Russian political regime. The research tools used in this research include case studies, content analysis of Russian speeches, and personal meetings of researchers and specialists in Russian affairs. It sums up a number of important conclusions, most notably are : 1) Putinism is a totalitarian regime that includes the political doctrine during the era of Russian President Vladimir Putin. 2) Duginism represents the totality of t
... Show MoreThe research seeks to examine the image of women in Iraqi films produced after 2003 over the answer to questions such as “ level of the representation of women and appearing in films and features that are attributable to them and their relationships with men and their interests and tendencies , activities and ways and methods pursued to achieve their goals , or what appeared to be trying to achieve and whether made movies vivid and varied models for women, or confined to a rigid model and duplicate Is films raised issues concerning women? The research seeks to examine the image of women in Iraqi films produced after 2003 over the answer to questions such as “ level of the representation of women and appearing in films and features th
... Show MoreThe current research aims to identify "the impact of the round table strategies and the question of self-achievement and self-efficacy among students of the Faculty of Education in research methodology course.” The research sample consisted of (75) male and female-third stage students in the department of Life Sciences / College of Education for Pure Sciences / University of Dhi Qar for the academic year (2018-2019. The researcher adopted the experimental approach to achieving the study objectives. The researcher prepared two tools: the achievement test and the self-efficacy scale were applied to the collected sample to obtain the needed data. The result showed that there was a statistically significant difference at the level (0.05) b
... Show MoreBackground: The treatment of an ovarian cyst relies on its nature, the discrimination of benign and malignant cysts is, therefore of crucial importance, and in spite of the continuous improvement of diagnostic means, it remains sometimes impossible to differentiate functional from organic (malignant or not) ovarian cysts. The therapeutic decision will search for the main midway between cancer’s negligence and the fear of performing an unnecessary surgical operation for an ovarian cyst.Objective: To review of 116 cases of ovarian cystic diseases aiming in identify proper management and reducing unnecessary surgical intervention.Methods: A retrospective study was conducted at Al-Elwiya maternity teaching hospital/ Baghdad/ Iraq. One hund
... Show MoreIn this paper, a relationship between the liquid limit and the coefficient of consolidation of Iraqi soils are studied. The samples of soil used in study are undisturbed silty clay. These samples are taken from different locations and depths of Middle and South of Iraq by cooperation with Consulting Engineering Bureau- University of Baghdad- College of Engineering. The depth reached about 20 meters. The experimental work is made to calculate the liquid limit and the coefficient of consolidation. From these sites, 280 points are obtained. The relationship between the liquid limit and the coefficient of consolidation is drawn as a curve. This curve is studied and compared with the curve that obtained from other studies. From these curves, it
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