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.
Numerous integral and local electron density’s topological parameters of significant metal-metal and metal-ligand bonding interactions in a trinuclear tetrahydrido cluster [(Cp* Ir) (Cp Ru)2 (μ3-H) (μ-H)3]1 (Cp = η5 -C5Me5), (Cp* = η5 -C5Me4Et) were calculated and interpreted by using the quantum theory of atoms in molecules (QTAIM). The properties of bond critical points such as the delocalization indices δ (A, B), the electron density ρ(r), the local kinetic energy density G(r), the Laplacian of the electron density ∇2ρ(r), the local energy density
... Show More
(4)
(1)
The purpose of this research shed light on the analysis of the relationship between the knowledge gap and the strategic performance gap and diagnose the level of impact this relationship in building a learning organization, and sought search to achieve a number of goals, cognitive and Applied been tested nature of the relationship and effect between variables in a sample size (62) of the managers of banks civil in Baghdad (Baghdad, Gulf, Assyria, Union, Elaf) and focused research problem in question is bold is whether the analysis of the relationship between the knowledge gap and the performance gap strategic leads to recognize organizations need to shift to organizations educated, either in the side of the field was the pr
... Show More
The research is based on the basic idea that companies today are moving towards a new trend towards protecting the environment coupled with the increasing wareness of the pollution damage caused by these companies due to their operations and activities in the environment. The two main reasons that led the researchers to choose this subject is the need to adapt the companies themselves in response to successive developments, The great development was that companies moved from the sole economic responsibility of the business to social responsibility by emphasizing socially responsible profit. The problem of research is the knowledge of the availability of the dimensions of the green processing series in Kirkuk Cement Factory The re
... Show More
|
The international organizations showed their interest in the marketable public relations, with their activities, means and strategies, they play a crucial role in marketing products, services and ideas of the institution. They are considered to be the link between the company and its public, They are responsible for presenting the institution to the public, with honest transmission of the information. This gives a good impression to the institution, in a way the institution and its products become consistent with the needs and interests of the public. Based on this, the research aims to identify the strategies used by the marketable public relations internationally. The r |
(2)
Background: During acrylic resin processing, the mold must be separated from the surface of the gypsum to prevent liquid resin from penetrating into the gypsum, and water from the gypsum seeping into the acrylic resin. For many years, tin foil was the most acceptable separating medium, and because it's difficult to apply, a tin-foil substitute is used. In this study, olive oil is used as an alternative to tin foil separating medium for first time, and evaluating its effect as a separating medium on some mechanical properties such as (indentation hardness and transverse strength) of acrylic resins denture base comparing it with those processed using tin-foil and tin foil substitute such as (cold mold seal) separating medium. Materials and M
... Show MoreThe educational service industry is one of the most negatively affected industries by the spread of the COVID-19 pandemic. Government agencies have taken many measures to slow its spread, and then restrict movement and gatherings and stop recreational activities. Furthermore, the repercussions of the curfew had a significant impact due to the interruption in actual attendance for students and employees, and the severity of the Covid-19 crisis and its (economic, social, security, humanitarian and behavioral) effects on all societies and work sectors is no secret to anyone. Iraq, like other countries, was also affected by the negative impact of Covid-19 pandemic in all fields of institutional work, especially public fields, and specifically t
... Show More
(13)
(13)
The performa of evaluation process is a process that should be carried out by all industrial management in order to stand on aspects of development or underdevelopment of the various departments and activities in its industrial project for the purpose of identifying obstacles and find out the causes and then avoid them quickly. And intended to rectify the performance evaluation of the activities of industrial project or economic union by measuring the results achieved within a specific operational process and compare it to what is already targeted, and often the time for comparison of one year.
The process of performance evaluation depends upon several criteria and indicators within the
... Show More
This study deals with the role of compensation system in improving the quality of educational services (University of Halabja as a Model) also our problem was the following question ; What is the role of compensation system in its different dimensions in improving the quality of educational services? And what is the relationship and impact of using the dimensions of the compensation system to improve the quality of educational services? The hypothesis of the research included the correlation and the impacts between the compensation system and its combined variables in the quality of educational services. This was proved through a field study and the distribution of questionn
... Show More
(1)
Brain Fingerprinting (BF) is one of the modern technologies that rely on artificial intelligence in the field of criminal evidence law. Brain information can be obtained accurately and reliably in criminal procedures without resorting to complex and multiple procedures or questions. It is not embarrassing for a person or even violates his human dignity, as well as gives immediate and accurate results. BF is considered one of the advanced techniques related to neuroscientific evidence that relies heavily on artificial intelligence, through which it is possible to recognize whether the suspect or criminal has information about the crime or not. This is done through Magnetic Resonance Imaging (EEG) of the brain and examining
... Show More