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.
Islamic banks are distinguished by providing banking activities that are unique in providing them from the rest of the other types of banks, and these activities are a group of banking services provided by the bank to its customers, whether these banking activities are tangible or intangible. At the same time, it is a source of bank profits, as Islamic banks impose a percentage of Islamic Murabaha on those banking activities , However, these banks have developed new services that they provide with the funds of the Central Bank initiative launched at the beginning of (2016) due to the economic conditions that befell the country due to the (financial security) crisis that the country faced in 2014. To put forward initiatives, and a
... Show MoreExperimental investigation for small horizontal portable wind turbine (SHPWT) of NACA-44, BP-44, and NACA-63, BP-63 profiles under laboratory conditions at different wind velocity range of (3.7-5.8 m/s) achieved in present work. Experimental data tabulated for 2, 3, 4, and 6- bladed rotor of both profiles within range of blade pitch angles . A mathematical model formulated and computer Code for MATLAB software developed. The least-squares regression is used to fit experimental data. As the majority of previous works have been presented for large scale wind turbines, the aims were to present the performance of (SHPWT) and also to make a comparisons between both profiles to conclude which is the best performance. The overall efficiency and el
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تتعامل الجهات الضريبية في مختلف دول العالم بأساليب عديدة لجباية الضرائب من المكلفين بغض النظر عن فئات وأصناف هؤلاء المكلفين،وفي العراق تم اعتماد العديد من الأساليب لجباية الضرائب على امتداد المدد الزمنية المتعاقبة،وكان لأسلوب التقدير الذاتي وهو أحد تلك الأساليب مجالاً للتطبيق خلال مدة زمنية معينة،حيث جرى تطبيق هذا الأسلوب على وحدات اقتصادية معينة، وبالرغم من المساوئ التي قد ترافق تطبيق
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Abstract This research deals with the definition of the concept of nodal purposes, And what is related to it, from its aim and importance, And for the purposes of the importance of Streptococcus In trying to understand the nodal truths For different minds, Especially with those who object to the introduction of belief in purposes studies, This research has two requirements: The first requirement: the concept and the aim of contractual purposes,It consists of two branches, The first is in the concept of nodal purposes, And it dealt with the definitions in terms of language and terminology And what we see is proportional to what aim |
Abstract:
This research aims to apply the Performance Focused Activity Based Costing System in the consultant office of Al-Khwarizmi College of Engineering at the University of Technology for the purpose of measuring the cost of consulting services provided by these offices in order to reduce costs and their reflection in achieving profits. For the purpose of calculating costs accurately, and to test the hypothesis of the research, the research was applied in the office of the consultant of the College of Engineering Al-Khwarizm - University of Baghdad through the financial statement
... Show MoreEvaluation is one of the most important elements of teaching process. The recent trends in evaluation and educational reform movements have called for using alternative evaluation, which focuses on performance evaluation. Authentic assessment is usually described as formative, in which students participate in their acquisition, in addition to the fact that students are productive and active, which is reflected in the students' achievement and skill level. The study aims to reveal the degree of knowledge and use of alternative assessment tools by primary school teachers in Gaza -Palestine. To meet the objective of the study, the researchers used the descriptive-analytical method and the questioner as a study tool. The study sample c
... Show MoreSlag of aluminum is a residue which results during the melting process of primary and secondary aluminum production. Salt slag of aluminum is hazardous solid waste according to the European Catalogue for Hazardous Wastes. Hence, recovery of aluminum not only saves the environment, but also has advantages of financial and economic returns. In this research, aluminum was recovered and purified from the industrial wastes generated as waste from both of State Company for Electrical and Electronic Industries (Baghdad/AlWaziriya) and General Company for Mechanical Industries (Babylon/-Al-Escandria). It was found that these wastes contain tiny proportions of other elements such as iron, copper, nickel, titanium, lead, and potassium. Wastes were
... Show MoreThe study aimed to prepare rehabilitation exercises using some rubber ropes for people with partial rupture of the anterior cruciate ligament, to recognize their effect on the recovery of motor tides and to reduce the pain of those with partial rupture of the anterior cruciate ligament of the knee joint, and adopted the experimental method by designing the experimental and controlled groups on a sample of those with partial rupture of the anterior cruciate ligament of men (30-35) One year of those who attend the Physiotherapy Center/Rafidain University College of 12 injured were deliberately selected from their community of origin by (100%), and after determining the measuring tools and preparation of exercises applied with rubber r
... Show MoreReligion in its general and simplified form is defined as a set of values or moral laws, which include provisions that people should follow to organize their affairs and ratify that they are provisions sent from the divine.
The concept of religion is not limited to the narrower sense represented by the performance of the virtual rituals of worship and religious fashions, etc., but also includes all the moral and spiritual values, conduct and good dealing that reflect the true essence of religion, which boils down to a set of values – such as sincerity, honesty and dedication to work, merciful dealing and compassion, etc. All religions agree on the moral content of religion. The Prophet of Is
... Show MoreThe research deals with one of the urban problems facing cities, namely the existence of neglected urban spaces that need to be activated , These spaces give a negative image of the city, is not conducive to life and social interactions or the city has a one distinctive urban experience, leading to a reduction peoples' confidence in revisiting of those areas, hinder the rest of the activities in that region . Because these spaces are of the basic components of the city and give it its identity through the elements and entities that constitute it , The idea of research emerged in the reclaiming of these spaces within contemporary urban trends and the activation of flexible , short-term and inovation for that purpose with
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