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 current research is attempt to test the reflection of the lean management on the human resources management practices of two of the most important communication companies operating in Iraq (`Zain & Asia cell), The research aims to Determine the extent of adoption of the lean management approach in the two researched companies, as it improving human resource management practices. The research problem represented in the existence of lack of in some aspects of the application the lean management approach in service sector and neglecting the impact of its tools on the human resource management practices. For this purpose three principle research hypotheses has been formulated, first there is a correlation rel
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Abstract Rasha Hameid Jehad Baghdad University Background: The high reactivity of hydrogen peroxide used in bleaching agents have raised important questions on their potential adverse effects on physical properties of restorative materials. The purpose of this in vitro study was to evaluate the effect of in-office bleaching agents on the microhardness of a new Silorane-based restorative material in comparison to methacrylate-based restorative material. Materials and method: Forty specimens of Filtek™ P90 (3M ESPE,USA) and Filtek™ Supreme XT (3M ESPE, USA) of (8mm diameter and 3m height) were prepared. All specimens were polished with Sof-Lex disks (3M ESPE, USA). All samples were rinsed and stored in incubator 37˚C for 24 ho
... Show MoreABSTRACT Background: Color changes that are detectable to human eye can affect the esthetic appearance of ceramic veneers. The purpose of this study was to evaluate and compare the effect of artificial accelerated aging on the color of ceramic veneers cemented with different resin cements. Materials and Methods: Sixty discs were prepared with 0.5 mm thickness, 30 discs made from IPS e.max press (Ivoclar Vivadent) and 30 discs were made from VITA Enamic (VITA Zahnfabrik). The discs were cemented with three resin cements: Variolink Veneer MV 0 shade (Ivoclar Vivadent), Rely X veneer Translucent shade (3M ESPE) and NX3 Nexus Clear shade (Kerr Corporation) with 0.1 mm thickness. The spectrophotometer Easyshade Advance was used to measure the co
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The research aims to improve operational performance through the application of the Holonic Manufacturing System (HMS) in the rubber products factory in Najaf. The problem was diagnosed with the weakness of the manufacturing system in the factory to meet customers' demands on time within the available resources of machines and workers, which led to time delays of Processing and delivery, increased costs, and reduced flexibility in the factory, A case study methodology used to identify the reality of the manufacturing system and the actual operational performance in the factory. The simulation was used to represent the proposed (HMS) by using (Excel 2010) based on the actual data and calculate the operational performance measures
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Abstract
The Paper highlights on one of the main activities in marketing management. That is the internal marketing in the commercial banks and its relationship with the quality services offered to satisfy customers needs and wishes in order to reach he ultimate objectives of those banks. Two state and five private banks in Basrah city (Iraq) were taken in a field study. The survey covered the opinions of (184) state bank employees and (158) clients . The analysis of the survey shows that there is a strong relationship between the internal marketing ( in the banks covered by the survey) and the quality of banking objective services and the private banks show greater interest and concern to the internal ma
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At the beginning of the nineties increased responsibility of the auditor to the community as the demand for auditing the environmental performance for the economic units in addition to audit the financial performance. With the aim of preserving the environment and reducing the damagse as aresult of the negative effects of the activities of these units.
The researh deal with two sides the first one identifies the theoretical framework of the concept of environmental audits, requirements, methods, types of procedures, and duties of the auditor in conducting environmental audits. It also deals with the concept of the enviro
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Polycystic ovary syndrome (PCOS) is a prevalent condition in women of reproductive age. It is characterized by androgen excess and chronic anovulation. Some trace elements, macroelements, and heavy metals have been linked to pathophysiological mechanisms of PCOS .
To study the alterations in the serum levels of the trace element manganese (Mn), some macroelements, magnesium(Mg) and calcium (Ca), and the heavy metals cadmium (Cd) and lead (Pb), in obese and non-obese PCOS patients; and the association of these alterations with some of the hormonal changes occurring in PCOS.
The study was carried out at Kamal Al-Samarrai Hospital (Center for Infertility treatment and in vitro Fertilization "IVF") Baghdad- Iraq. Eig
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