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.
Spiritual is one of modern subjects gained importance of their role in the meaning imparted to work and to promote a sense of belonging to the group and the community, including support personnel positive attitudes towards their work. The research aims to highlight the impact of the relationship between workplace spiritual and variable working attitudes to sample variant of the hospitals, health department BAGHDAD / Rusafa, and in order to achieve this, the researcher is based on the descriptive and analytical approach adopted for the analysis of the questionnaire and to test relations research and its variables. The research community (4) of hospitals in Sadr City, included've targeted 106 doctors and 222 nurses formed a whole (
... Show MoreThe present research tackles a number of historical facts and incidents with a purely legal dimension in an important stage in the contemporary history of Iraq, especially the era of the British occupation. This resulted in innumerable social, political and legal problems, particularily the judicial legislation problems in Iraq. These legislations included a set of civil laws and in force governmental procedures that will be discussed historically by examining documents issued by the Ministries of Justice and Interior Affairs in the governments of monarchy for the period from 1921-to-1958. The data of the present paper relied on the Iraqi Library and Archives, (hence DKW). The study adopted the narrative historical methodology when inves
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This study aims to identify the issue of observing media publishing and its importance for public relations in the management of special events; and its role in building the positive image of the target audience through communication messages that illustrate the political, economic and diplomatic importance of the Arab Summit. As such Summit is one of the conferences that Iraq sought to secure the requirements of its convening to re-activate its political and diplomatic role in the Arab Ocean, especially after the circumstances and crises that Iraq went through.
The convening of the Arab Summit under the auspices of Iraq was a qualitative transition, during which Iraq sought to achieve some gains b
... Show MoreThe emergence of oil fields and subsequent changes in adjacent land use are known to affect settlements and communities. Everywhere the industry emerges, there is little understanding about the impact of oil fields on land use in the surrounding areas. The oil industry in Iraq is one of the most important industries and is almost the main industry in the Iraqi economic sector, and it is very clear that this industry is spread over large areas, and at the same time adjoins with population communities linked to it developmentally.
The rapid development and expansion of oil extraction activities in various regions has led to many challenges related to land-use planning and management. Here, the problem of research arises on th
... Show MoreThis paper presents ABAQUS simulations of fully encased composite columns, aiming to examine the behavior of a composite column system under different load conditions, namely concentric, eccentric with 25 mm eccentricity, and flexural loading. The numerical results are validated with the experimental results obtained for columns subjected to static loads. A new loading condition with a 50 mm eccentricity is simulated to obtain additional data points for constructing the interaction diagram of load-moment curves, in an attempt to investigate the load-moment behavior for a reference column with a steel I-section and a column with a GFRP I-section. The result comparison shows that the experimental data align closely with the simulation
... Show MoreTransportation and distribution are the most important elements in the work system for any company, which are of great importance in the success of the chain work. Al-Rabee factory is one of the largest ice cream factories in Iraq and it is considered one of the most productive and diversified factories with products where its products cover most areas of the capital Baghdad, however, it lacks a distribution system based on scientific and mathematical methods to work in the transportation and distribution processes, moreover, these processes need a set of important data that cannot in any way be separated from the reality of fuzziness industrial environment in Iraq, which led to use the fuzzy sets theory to reduce the levels of uncertainty.
... Show MoreThis study compared in vitro the microleakage of a new low shrink silorane-based posterior composite (Filtek™ P90) and two methacrylate-based composites: a packable posterior composite (Filtek™ P60) and a nanofill composite (Filtek™ Supreme XT) through dye penetration test. Thirty sound human upper premolars were used in this study. Standardized class V cavities were prepared at the buccal surface of each tooth. The teeth were then divided into three groups of ten teeth each: (Group 1: restored with Filtek™ P90, Group 2: restored with Filtek™ P60, and Group 3: restored with Filtek™ Supreme XT). Each composite system was used according to the manufacturer's instructions with their corresponding adhesive systems. The teeth were th
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The aim of the research is to demonstrate the impact of long-term investment on profitability, and in order to achieve this goal, long-term investment was chosen, represented by (the ratio of long-term investments to total investments, the ratio of long-term investment to the total (deposits) as independent variables, and studying its impact on the dependent variable, which is profitability as measured by the rate of return on investments, the rate of return on equity. In order to reach the results, the inductive approach and the analytical descriptive approach were used, and the research found a significant impac
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