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 surgery Keywords: Non-surgical treatment of anal fissure, fissure in ano, sphicterotomy,botulinum toxin in anal fissures, glyceryl trinitrate. Chemical sphincteratomy, pharmacological sphincteratomy.
Health and safety problem can be described by statistics it can only be understood by knowing and feeling the pain, suffering, and depression. Health and safety has a legal responsibility to protect it for everyone who can affect in the workplace. This includes manufacturers, suppliers, designers and controllers of work places and employees. Work injury is one of the major problems in manufacturing and production systems industries; it is reduced production efficiency and affects the cost. To gain flexibility from a traditional manufacturing system and production efficiency, this paper is about the application of estimating technology to preview and synthesis of Lost Time of Work Injuries in industry systems aims to provide a safe workin
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A faunistic review of the genus Chaitophorus Koch, 1854, including four species in Iraq is given; the distribution data of each species and their hosts have been recorded. In this investigation the poplar leaf aphid Ch. populialbae (Boyer de Fonscolombe, 1841) is recorded here for the first time in Iraq on popular trees Populus euphratica Oliv. during the period from November 2016 to April 2017 in Baghdad province.
A brief description for apterous viviparous female of this species is given; and a key to the species of the genus Chaitophorus is constricted.
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The process of coordination and joint cooperation between SAIs and internal auditors in the public sector is considered one of the very important matters in performing efficient audits and are of high quality, especially if this coordination and cooperation is implemented in accordance with international standards, as it leads to avoiding duplication in auditing work. And the distribution of work in a distribution that achieves the objectives of auditing in general and is of general benefit to the economic unit.
The research problem lies in the weakness of the relationship between internal auditing and external auditing as a result of not applying INTOSAI Standard (9150) coordination and joint cooperation
... Show MorePurpose: We report a series of 29 pediatric patients who sustained head injuries due to metallic ceiling fans. They all were admitted to the Emergency Department of Neurosurgery Teaching Hospital in Baghdad, Iraq, during January 2015 to January 2017. Results: Pediatric ceiling fan head injuries are characterized by four traits which distinguish them from other types of head injuries; 1- Most of them were because of climbing on or jumping from furniture between the ages of two and five. 2- Most of them sustained compound depressed skull fracture which associated with intracranial lesions and pneumocephalus. 3- The most common indication for surgical intervention was because of dirty wound which mixed with hairs. 4- These variables were stati
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The study aims to investigate the effect of the Six Thinking Hats Strategy on the achievement of essay writing skills among third-year students in Arabic Language and Literature who are Persian speakers enrolled in the course of Essay Writing (III) at Shiraz University for the academic year 2019-2020. The sample of the study consisted of (15) male and female students who were taught according to the pre-posttest, using the quasi-experimental approach. After applying the statistical analysis on the scores of the post-test, the results showed that there are statistically significant differences in the average of students' achievement in the skills of essay writing in terms of using the Six Thinking Hats Strategy. The results also proved th
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Abstract
Indeed, being busy with the understanding of religion is the best sort of worship that the almighty God has given each period of time a number of scholars and wise men. They receive what has been passed down to them from their great ancestors, and those who are willing to learn will learn, their students preserve their knowledge through teaching and writing. Thus, the scholars were pioneers in this field due to the value and importance of their knowledge. They have strived in learning, explaining, and writing new subjects.
One of those scholars is sheikh (Abdulrahman Al-Penjweni) who passed away 1319 AH in one of the villages of the city of Sulaimani in Iraq. He was one of the wisest scholars, a br
... Show MoreLanguage always conveys ideologies that represent an essential aspect of the world we live in. The beliefs and opinions of an individual or community can be organized, interacted with, and negotiated via the use of language. Recent researches have paid attention to bullying as a social issue. They have focused on the psychological aspect of bullying rather than the linguistic one. To bridge this gap, the current study is intended to investigate the ideology of bullying from a critical stylistic perspective. The researchers adopt Jeffries' (2010) critical stylistics model to analyze the data which is five extracts taken from Hunt’s Fish in a Tree (2015). The analysis demonstrates
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Declaration has become today has an important and active and influential role in the recipient public life، and are concentrated advertising on the creativity component manufacture to attract his attention toward what to be announced from a variety products، and is dominated by television commercials tempo and imagination، and display them a variety of ways catches the attention and an impressive simulates the their senses of hearing and sight، to influence in the receiver and the public paid for purchase. Through it crystallization the subject of our research on the importance of creativity in television advertising and effective for attracting the attention of the publi |
This paper generalizes and improves the results of Margenstren, by proving that the number of -practical numbers which is defined by has a lower bound in terms of . This bound is more sharper than Mangenstern bound when Further general results are given for the existence of -practical numbers, by proving that the interval contains a -practical for all
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