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.
Credit derivatives (CDs) have been increasingly acknowledged as an important requirement to hedge and transfer credit risk CR. Nonetheless, they have been extensively criticized for destabilizing the whole economic system bringing about the latest subprime credit crisis. The study’s main aim is to investigate the reason for the use of (CDs), whether it is used for hedging or trade purpose, for four of the US international financial institutions that had made it through the 2007 crisis to resume functioning post-crisis. This will be for three different and critical periods, namely the pre, during and after crisis periods (Q1, 2000-Q1, 2014). Adopting the SUR technique, the investigation of the factors that influence the net position of (CD
... Show MoreThe study aims to identify the concept of empowering women from the point of view of experts in the Palestinian society, specifically in Gaza, as well as to explore the foundations of their formation of this concept. Additionally, the study seeks to clarify the most important challenges facing the empowerment of women in Palestinian society. The study used the design of a grounded theory that seeks to build the theory through deep analysis of the data, as qualitative data were collected through holding two focus groups and six in-depth interviews with the study sample, who were selected by the method of targeted sampling. The sample included (16) individuals (9 female experts, 7 male experts) holding academic and community leadership pos
... Show More There is an increase in the need for cost accounting in all organizations and from different sectors to provide detailed information to the totals of financial accounting, first and help solve problems associated with inventory and analysis, tabulation and allocation of cost elements II and do the planning process and provide the necessary oversight and help to take the right decisions such as pricing decisions that need to Information cost accounting.
And suffer most of the non-governmental organizations from the lack of a cost accounting system provides information on the cost of service in these organizations and the department research sample circle v
Indicators of government debt is of extreme importanse in economic activity through knowledge of the economic impact of government debt, if the phenomenon is accepted or prepared to dangerous stage by stage, and there fore it can Through these indicators to measure the degree of indebtedness in relation to the economic activity of the Government on the one hand, the governments ability to repay the other hand.
Due to this it inferred that the degree of indebtedness in Iraq specificratio has exceed 60% during the period 1990 – 2002 ntejh lack of political and economic stability of the government, which led to the governments inability to repay the ma
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The research aims to monitor the image of the man in the group (The Cart and the Rain) by the storyteller (Badiaa Amin); With the aim of highlighting an aspect of feminist writing, especially with regard to the relationship of women to men, and determining the form adopted by the storyteller in drawing the features of men.
The research used the descriptive-analytical method in the space of its textual formation, which aims to stand on the text and deconstruct its narrative significance. To provide a comprehensive picture of it.
Three images of the man appeared in the group's stories, represented by (the authoritarian, the negative, and the positive), and the image of the authoritarian ma
... Show MoreIn order to understand the effect of (length of pile / diameter of pile) ratio on the load carrying capacity and settlement reduction behavior of piled raft resting on loose sand, laboratory model tests were conducted on small-scale models. The parameters studied were the effect of pile length and the number of piles. The load settlement behavior obtained from the tests has been validated by using 3-D finite element in ABAQUS program, was adopted to understand the load carrying response of piled raft and settlement reduction. The results of experimental work show that the increase in (Lp/dp) ratio led to increase in load carrying capacity by piled raft from (19.75 to 29.35%), (14.18 to 28.87%) and (0 to 16.49%) , the maximum load carried
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In the present study, composites were prepared by Hand lay-up molding. The composites constituents were epoxy resin as a matrix, 6% volume fractions of glass fibers (G.F) as reinforcement and 3%, 6% volume fractions of preparation natural material (Rice Husk Ash, Carrot Powder, and Sawdust) as filler. Studied the erosion wear behavior and coating by natural wastes (Rice Husk Ash) with epoxy resin after erosion. The results showed the non – reinforced epoxy have lower resistance erosion than natural based material composites and the specimen (Epoxy+6%glass fiber+6%RHA) has higher resistance erosion than composites reinforced with carrot powder and sawdust at 30cm , angle 60
... Show MoreAthletics are different from other games as a competition between individuals to show their competence and physical ability to achieve new record numbers in the various activities and various between the boards, jumping and throwing and each type of these activities in particular performance so found the researcher to find the method of training resistors in the development of special power and achievement In the effectiveness of javelin, where the researchers chose the sample of the athletes from the specialized school of athletics to effectively throw the spear at the ages of 15-17 years and carried out the tests of the research, which includes the strength of the speed of the arms and explosive power and The various resistance exercise
... Show MoreBackground: Disc battery ingestion is a common
serious problem in Iraq. It increase in the last years
because of the increase in number of electronic toys
that uses these batteries. These batteries contains
many types of irritant chemicals that increases the
risk of it's ingestion.
Methods:We reviewed the medical records of
children aged between 1year and 7 years
old admitted to Surgical Specialty Hospital/Baghdad
Medical City due to disc battery ingestion from
January 2007 through December 2010). The diagnosis
of disc battery ingestion was based upon history,
clinical symptoms, and results of imaging studies.
The clinical data reviewed included sex, age, clinical
manifestation and duration of sy
The problem of generated waste as a result of the implementation of construction projects, has been aggravated recently because of construction activity experienced by the world, especially Iraq, which is going through a period of reconstruction, where construction waste represents (20-40%) of the total generated waste and has a negative effect on the environment and economic side of the project. In addition, the rate of consumpted amounts of natural resources are estimated to be about 40% in the construction industry, so it became necessary to reduce waste and to be manage well. This study aims to identify the key factors affecting waste management through the various phases of the project, and this is accom
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