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.
The aims of this study are to measure the defect rate and analyze the problems of production of ready concrete mixture plant by using Six Sigma methodology which is a business strategy for operations improvement depending basically on the application of its sub-methodology DMAIC improvement cycle and the basic statistical tools where the process sigma level of concrete production in the case study was 2.41 σ.
The corrosion behavior of low carbon steel in washing water of crude oil solution has been studied potentiostatically at five temperatures in the range (30–70)°C .The corrosion potential shifted to more negative values with increasing temperature and the corrosion current density increased with increasing temperature. Folic acid had on inhibiting effect on the corrosion of low carbon steel in washing water at a concentration (5× 10-4-- 5× 10-3 ) mol/dm3 over the temperature range (30–70)°C. Values of the protection efficiency were calculated from the corrosion current density .From the general results for this study, it can be seen that thermodynamic and kinetic function were also calculated (?G, ?S, ?H and Ea )
... Show MoreBackground: Incorporation of chemical additives has long been a technique used to improve properties of the gypsum products. The purpose of this work was to study the effects of adding a combination of gum Arabic and calcium hydroxide to a type III dental stone and type IV improved die stone with different proportion. The effect on water/powder ratio, and surface hardness was determined. Material and method: Both material stone and die stone were blended with two proportion of additives so that each material was mixed twice but with different proportion of gum Arabic (0.1% and 0.2%) and calcium hydroxide (0.5 % and 0.3%). Data for hardness were subjected to two-way analysis of variance. Results: The results revealed that the chemical additi
... Show MoreBackground: Saliva is one of the most important etiological host factors in relation to dental caries. It affects the carious process by its organic and inorganic constituents; in addition to its physiological functions as (flow rate, pH and buffer capacity). The aims of this study were to determine the concentrations of major elements (calcium and phosphorus) and trace elements (ferrous iron, nickel, chromium and aluminum) in saliva among a group of adolescent girls, and to explore the relation of these elements, flow rate and pH with dental caries. Material & Methods: The study group consisted of 25 girls with an age of 13-15 years old. Dental caries was diagnosed by both clinical and radiographical examinations following the criteria of
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The internal audit is considered the safety valve for senior management in all institutions. It aims to protect property, and raise the efficiency and effectiveness of the administrative performance, by following up on compliance with laws and instructions and the application of regulations in a way that increases the administrative performance of the department. The internal audit is possible to determine Weaknesses or imbalances in the administrative performance. To achieve this goal, an analytical descriptive methodology was adopted. The Baghdad Health Department / Al-Rosana was considered as society for this s
... Show MoreThe contemporary business environment is witnessing increasing calls for modifications to the traditional cost system, and a trend towards adopting cost management techniques to provide appropriate financial and non-financial information for senior and executive departments, including the Resource Consumption Accounting (RCA) technique in question, which classifies costs into fixed and variable to support the decision-making process. Moreover, (RCA) combines two approaches to cost estimation, the first based on activity-based cost accounting (ABC) and the second on the German cost accounting method (GPK). The research aims to provide a conceptual vision for resource consumption accounting, after Considering it as an accounting te
... Show MoreObjectives: This study aims to assess and compare the micro-shear bond strength (μSBS) of a novel resin-modified glass-ionomer luting cement functionalized with a methacrylate co-monomer containing a phosphoric acid group, 30 wt% 2-(methacryloxy) ethyl phosphate (2-MEP), with different substrates (dentin, enamel, zirconia, and base metal alloy). This assessment is conducted in comparison with conventional resin-modified glass ionomer cement and self-adhesive resin cement. Materials and methods: In this in vitro study, ninety-six specimens were prepared and categorized into four groups: enamel (A), dentin (B), zirconia (C), and base metal alloys (D). Enamel (E) and dentin (D) specimens were obtained from 30 human maxillary first premolars e
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The research aims to improve the insurance service through the marketing commission as a tool that enables the insurance companies to achieve a competitive advantage. The researcher, by observing the challenges faced by insurance companies, insurance agents and brokers, raised the main question of the research: Is there an effect of the marketing commission on the competitive advantage of insurance companies? The data was obtained through the financial statements and annual reports of the research sample companies (the National General Insurance Company, the Iraqi General Insurance Company, Al-Hamra Private
... Show MoreThe main problem of this research is the delay of implementation of the investment plan projects for the period (2013-2016) and the weakness of the staff ability in the ministries and they don’t have the sufficient experience to carry out the implementation process.
Therefore, the research aims to evaluate the implementation of programs and projects of the investment plan in a manner consistent with the objectives set for them without any wasteful of efforts, time and money. And then identify the problems and obstacles to determine the deviations of the implementation of the specific for each sector according to the criteria of evaluation and the form of cost, quality, time and implementation.<
... Show MoreThis paper is submitted as anew approach to simulate manufacturing control & planning system to define the problem of designing control system on the needs for materials.
Production planning & control is a total and complex operation, resides in the essence of manufacturing companies operations. The successful process of production planning and control systems is critical for the staying of manufacturing organizations in markets leading to the increasing consumer competition and which dominate most of manufacturing sectors because of the market oriented economy , thus , what has happened previously , that the companies possessed a great inventory of crude material, components, and groupings and they use in flexible techni
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