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.
The aim of the research is to demonstrate the importance of leadership empowerment in its dimensions (knowledge, participation in decision-making, incentives, trust between the leader and subordinate, delegation of authority and communication) and its impact on enhancing the effectiveness of the company in its dimensions Represented by (achievement of objectives, quality of insurance service, adaptation to work environment and job satisfaction), by adopting the questionnaire as a main tool in collecting data from officials in the National Insurance Company, numbering (56) surveyed in job sites (section manager, division official and unit official) Their answers were analyzed using the SPSS statistical program in calculating the a
... Show MoreIraq within the ranks of the fledgling communities characterized by a broad base of the population pyramid, because they pose the age group (under 15 years) of a large proportion of the community, as it exceeded the proportion (40%) during the years of research extended (1986-2010) Despite the relative decline in the rates fertility during that period, but the proportion of young people remained high, especially for groups of at least five years, amounting to about 14% in 2012, a little more than the proportion of what constitutes age group (5-9 above) years, where it was (13%) and this naturally predicts continuing population increases in coming decades, due to the entry of those numbers of individuals in the reproductive stage,
... Show MoreThe aim of the research is to diagnose the nature of the relationship between the dimensions of organizational immunity with its dimensions represented by (organizational memory, organizational DNA, organizational learning) in enhancing the strategic capabilities of the company with its dimensions represented by (marketing capabilities, administrative capabilities, technological capabilities, creative capabilities), and the degree of arrangement of those dimensions According to priority, as well as revealing the differences in the respondents’ response to the two variables according to the personal and functional variables, and the importance of the expected results, the researchers adopted the questionnaire as a tool for collecting da
... Show MoreThe current research seeks to Analyze third intermediate chemistry book following sustainable development standards for academic year (2016-2017). To do this, a list of sustainable development standards that should be included in chemistry book was designed based on the previous studies. The first version of the list consisted of (50) sub-case divided into three standards (social, economic, and environmental) which was exposed to group of experts in teaching chemistry and teaching methods. The list has modified to (43) sub-case. The researcher followed the implicit and explicit meaning in his analysis: one for recording and repetition and the other for frequency. The result showed that third intermediate chemistry book has achieved (20)
... Show MoreThis study aims to know the extent of the impact of Strategic Leadership as an independent variable in Strategic Learning as a dependent variable to help the senior leadership in Anbar University to take the right decisions to develop Strategic Learning programs in light of the circumstances of the Covid-19 and the sudden decisions adopted by the university to switch to E-learning and to blend. The survey was conducted by distributing a questionnaire that was adopted as a primary tool in data collection from the study sample represented by the university's senior leaders, An intentional random sample of (105) was selected from our community of (127), the data were analyzed by (SPSS) Depe
... Show MorePraise be to God, Lord of the Worlds, who has made His way for His servants who know in the depths and who are devoted to Him at all times and times, so He has delivered to Himself their pain from two exiles, and His prayers and peace are the perfect trust in the presence of the pearl of charity of existence. Possessor of great intercession and praiseworthy status until the day of meeting and eternity, and upon his family and companions, the people of tomorrow, steadfastness, generosity, and generosity, and after that
For a long period of time, I have been asking myself: Why did he attack so many contemporary books, especially Sufism? Why this unlimited financial expenditure on printing, binding, beautifying and enticing readers?
... Show MoreObjective: Assessment the psychological problems in patients with colorectal cancer, and to find out the
relationship between socio-demographic characteristics such as (age, sex, marital status, educational level,
and occupation) and psychological problems for those patients.
Methodology: A descriptive design is employed through the present study from 1
st July 2011 to 25
th December
2011 in order to study the quality of life in colorectal cancer patients with psychological problems.
A purposive (non probability) sample is selected for the study which includes (60) patients diagnosed with
colorectal cancer were treated in Mosul Oncology and Nuclear Medicine hospital or the patients who visited
the outpatient cl
This study measured and analyzed job satisfaction among faculty members at the university of Irbid College in relation to gender social status, years of experience, academic rank , qualification, the population consisted of 110 full-time Jordanian factually members. A total of 72. (61%) factually, members participated in this study. The research instrument which was developed by the researcher consisted of tow parts: personal information and the job Satisfaction Questionnaire Frequencies, percentages, means and one-way analyses of variance were employed to analyze the data. The level of significance was set at 0.05. A Secheffe method of multiple comparisons was used for follow-up investigation.
... Show MoreTo investigate the research objectives, the researchers put the following hypothesis:
There was no statistically significant difference at the level of (0.05) between the average score of the students of the experimental group who studied the language of rhetoric according to model of learning method, and the average score of the students of the control group who studied the same article in the traditional way acquiring rhetorical concept. The researchers relied on the experimental design with the partial setting of the post-test, which depends on the experimental group that is taught using the model of the learning method, and the control group taught using the traditional method.
... Show MoreObjective(s): This study aims to assess health related quality of life among Iraqi patients with chronic viral hepatitis
B and C also to find out the relationship between health related quality of life and patients demographic
characteristic and to design a new measurement scale for assessing QoL among viral hepatitis B and C patients
which can be suitable to be adopted for Iraqi patients
Methodology: A descriptive quantitative study is carried out at Gastroenterology and Hepatology Teaching
Hospital from February, 1st, 2011 to August 30th 2011, Anon probability (purposive sample) of (100) chronic viral
hepatitis B and C persons , who were clients of Gastroenterology and Hepatology Teaching Hospital / outpatient
clin