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 study aimed to prepare a practical guide for procedures for auditing the strategies of municipal institutions in achieving sustainable development by adopting the idea of the audit matrix through which a classified report is prepared according to the dimensions of sustainable development, by preparing a specialized audit program for the purpose of auditing strategies for achieving sustainable development and emptying the results of the application of each of the paragraphs The program in the audit matrix that was prepared for the purpose of determining the impact of each observation and linkin
... Show MoreThe petroleum industry, which is one of the pillars of the national economy, has the potential to generate vast wealth and employment possibilities. The transportation of petroleum products is complicated and changeable because of the hazards caused by the corrosion consequences. Hazardous chemical leaks caused by natural disasters may harm the environment, resulting in significant economic losses. It significantly threatens the aim for sustainable development. When a result, determining the likelihood of leakage and the potential for environmental harm, it becomes a top priority for decision-makers as they develop maintenance plans. This study aims to provide an in-depth understanding of the risks associated with oil and gas pipeli
... Show MoreThe research dealt with a topic that has been practiced and transmitted news in satellite channels in recent years a lot. That is to say the role of satellite channels in the culture of a protest. In general, this study aims to reach to know the extent of the impact of television, especially the impact of the programs that bear the contents of protest and remonstration on the public; and what can be resulted out of these programs as cognitive, emotional and behavioral effects as a result of the individual's exposure to these programs and their impact from the culture of pretense. In addition to that, the research was interested in explaining the role of Iraqi satellite channels in developing and cultivating such culture; and following up
... Show MoreLet R be a 2-torision free prime ring and ?, ?? Aut(R). Furthermore, G: R×R?R is a symmetric generalized (?, ?)-Biderivation associated with a nonzero (?, ?)-Biderivation D. In this paper some certain identities are presented satisfying by the traces of G and D on an ideal of R which forces R to be commutative
ABSTRACT
The controversy is currently revolving around industrial additives, including antioxidants, their negative effects on consumer health and the emergence of various and various diseases, which led scientists and researchers to intensify most studies on natural antioxidants and their synthesis from medicinal plants mentioned in ancient medicine and in divine books as potential antioxidants of increasing importance. Therefore, this study was designed to synthesize silver nitrate particles from plant leaf extracts (Figs, Olives, and Moringa) and study their effect on bacterial inhibition of each of the undesirable Coliform bacteria (E-Coli,
... Show MoreThis research examines the impact of cornering on the aerodynamic forces and stability of a Nissan Versa (Almera) passenger sedan car by introducing novel modifications. These modifications included single inverted wings with end plates as a front spoiler, double‐element inverted wings with end plates as a rear spoiler, and incorporating the ground as a diffuser under the car trunk. The goal is to enhance the performance and stability of conventional passenger cars. To ensure the accuracy of the numerical data, the study utilized multiple methodologies to model the turbulence model, ultimately selecting the most suitable option. This involved comparing numerical data with wind tunnel experimental d
The administrative leadership relies on a variety of behavioral paths in the functional areas in which it operates, and thus indicates its ability and thus has the upper hand in the organizational events, and in such a way that it can draw lessons and evaluate the results so as to test the expectations within the framework of the changes.
Does the study sample leadership have the characteristics that enable it to contain both crises and environmental stresses?
The aim of the study was to determine the location of the administrative leaders in the system of the study sample from the issue of crises and environmental pressures. The study concluded with a number of conclusions, the m
... Show MorePurpose - This study relies on the descriptive and analytical approach through collecting and analyzing the necessary data, as this approach focuses on polling the opinions of the research sample and its directions, and aims to develop a model that studies the relationship between knowledge creation and organizational ambidexterity in Iraqi private banks and verifying its validity experimentally.
Design / Methodology / Introduction - A survey was conducted through a questionnaire form to collect data from a sample of (113) managers in private commercial banks. In addition, this study used the AMOS program and the ready-to-use statistical program package (SPSS V.25) to test the proposed hypotheses of the t
... Show MoreThe research aims to shed light on the concept of Visibal management and its reflection on the organizational culture of the organization. The visual administration is a modern administrative method that contributes to the renewal and development of the organization's reality through surveying the opinions of a sample of 61 employees in the R & D / Ministry of Higher Education and Scientific Research. (130) individuals. The questionnaire was used as a main tool for collecting data and information, and their answers were analyzed using the SPSS program in data entry and analysis. The most important tools are computational circles, standard deviations, method of analysis and regression equation. There is a possibility to apply
... Show MoreHuman behavior is one of the topics that has captured the attention of researchers throughout the ages, and motivation is one of the manifestations of this behavior, which indicates the extent of interest in a particular topic and their unwillingness to rush towards a particular topic. The topic of motivation is one of the important topics of interest to the teacher and coach in the field of sports. The aim of this research was identifying the level of motivation for junior students, and the differences in the dimensions of motivation for junior students in squash lessons. We used the descriptive survey method, and the research sample was chosen randomly. Only male of the junior students in the College of Phys
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