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 research aims to improve the effectiveness of internal control system according to a model COSO, by identifying the availability of system components according to the model and then improve the effectiveness of each component by focusing on areas for improvement in each component, as it was addressed to a model COSO and then Maamth with the environment, the current Iraqi by introducing some improvements on the form of some mechanisms of corporate governance of the Council of Directors, and senior management, the Audit Committee, Committee appointments, especially that supplies application available in the laws and legislation, the current Iraqi, taking into consideration to make some
... Show MoreBurnishing improves fatigue strength, surface hardness and decrease surface roughness of metal because this process transforms tensile residual stresses into compressive residual stresses. Roller burnishing tool is used in the present work on low carbon steel (AISI 1008) specimens. In this work, different experiments were used to study the influence of feed parameter and speed parameter in burnishing process on fatigue strength, surface roughness and surface hardness of low carbon steel (AISI 1008) specimens. The first parameter used is feed values which were (0.6, 0.8, and 1) mm at constant speed (370) rpm, while the second parameter used is speed at values (540, 800 and 1200) rpm and at constant feed (1) mm. The results of the fatigue
... Show MoreCoaches and analysts face a significant challenge of inaccurate estimation when analyzing Men's 100 Meter Sprint Performance, particularly when there is limited data available. This necessitates the use of modern technologies to address the problem of inaccurate estimation. Unfortunately, current methods used to estimate Men's 100 Meter Sprint Performance indexes in Iraq are ineffective, highlighting the need to adopt new and advanced technologies that are fast, accurate, and flexible. Therefore, the objective of this study was to utilize an advanced method known as artificial neural networks to estimate four key indexes: Accelerate First of 10 meters, Speed Rate, Time First of 10 meters, and Reaction Time. The application of artifi
... Show MoreIn this article it is proved experimentally that the photon is a particle that has mass and constant wavelength by explaining the effect of refractive index on the wavelength and the natural mass of photon. It is very difficult to measure the mass of photon, a simple and easy process was proposed in this paper to calculate the mass length of photon in vacuum (Y) and in medium (Y*), by measuring the length of laser beam in air (Lair) and in medium (Lmed). A new method was postulated to calculate refractive index by using these relations (n = Y*/Y), and (n = Lmed / Lair) which supposed a new theory of light.
The auditor has a role in allocating joint costs in the gas industry, and the auditor's procedures are considered as systematic critical examination, analysis and evaluation of everything related to costs in general and joint costs in the gas industry in particular, with the aim of controlling the joint costs of gas industry products, and knowing the share of the cost of each product from the total industry costs Gas products reflect the reality of the company's performance by discovering weaknesses, defects and any errors, to ensure increased effectiveness and efficiency of the parties concerned with auditing them and imposing control and control over the company's resources, as well as
... Show MoreThe objective of the research is to shed light on the nature of the impact of the activities of the national strategy for poverty alleviation in achieving the goals of sustainable development, and the research problem was represented by Is there an effect of the activities of the national strategy for poverty reduction in achieving the goals of sustainable development? and represents the field of research in the Ministry of Labor and Social Affairs For the years (2012-2016) and the results of the sustainable development goals indicators for the years (2012-2016), the ready-made statistical program (SPSS ver.10) was used to calculate the percentages, multiple linear regression equation, the F test and the R2 coefficient, and the research
... Show MoreThis paper aims to identify the contents of the advertisements of the (Take the Vaccine .. to Protect Yourself) campaign that was carried out by the Iraqi Ministry of Health for the period from (11/19/2020) to (4/1/2022), to raise awareness of the anti-Covid 19 virus vaccines, which it published on its official page on Facebook. The researcher used a comprehensive inventory method for the research community, and used the content analysis tool.
... Show MoreAdyertising sponsorship is one of the most prominent public activities, hich drives many public relations relations practitioners in companies to rely heavily on it in order to achieve positive results that contribute to the marketing of the brands of these sponsoring companies. The problem of Our research can be identified by the main question: What is the role of advertising sponsorship in brand marketing "The research aims to identify the role of sponsorship in brand marketing, and its role in attracting the public's attention to the products of the sponsors. As well as clarifying the role of the care method in the popularity of the products of the Sponsorship companies.
A developed model has been put for the hypothesis of capturing moons in explaining the origin of Jupiter moons, and study the change of the orbital properties of these satellites as well as the distance from the planet. Jupiter moons were divided into two types according to their physical and orbital properties, they are the moons , which are formed from the same material as the planet, so it was named the original moons ,while the moons that have been captured from the surrounding space was renamed exotic moons . And the moons of exotic origin asteroid belt and the Kuiper belt in the region which is behind Neptune, the origin of each clique of moons is an asteroid fragmented after colliding previously with another body and
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The study aims to know the degree of secondary school managers' practice of servant leadership in Gaza from their teachers’ perspective. It further aims to examine whether there are any statistically significant differences at (α 0.05≥) between the means of the study sample’s members attributed to variables such as (gender, educational qualification, and years of experience). To achieve the objectives of the study, the study adopted the descriptive survey method, using a questionnaire consisting of (30) items distributed to four domains: (workers service, ethical dealing, motivation & influence, and building an organized, integrated society). Then, the questionnaire was distributed to t
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