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 research aims to analysis of the current financial crisis in Iraq through knowing its causes and then propose some solutions that help in remedy the crisis and that on the level of expenditures and revenues, and has been relying on the Federal general budget law of the Republic of Iraq for the fiscal year 2016 to obtain the necessary data in respect of the current expenditures and revenues which necessary to achieve the objective of the research , and through the research results has been reached to a set of conclusions which the most important of them that causes of the current financial crisis in Iraq , mainly belonging to increased expenditures and especially the current ones and the lack of revenues , especially non-oil o
... Show MoreThe organizations and institutions of the developed countries have given attention to the subject of the knowledge economy by using advanced technology in the function of tax examination because of the important and effective role in ensuring the accuracy of the tax accounting process procedures, But the General Commission of taxes is still using traditional methods in the field of tax examination which affects the performance of its work. This research aims to explain the level of effect on introducing advanced methods of Economics and knowledge represented by advanced communication technology in the field of practicing tax examination function in the General Commission of taxes, A questionnaire has been used as a mea
... Show MoreObjective: The purpose of this study was to assess the effectiveness of Vibriophage Universiti Sains Malaysia 8 (VPUSM 8), a bacteriophage that destroys bacteria, in managing the proliferation of Vibrio cholerae, specifically the El Tor serotype, as an alternate therapeutic strategy. Methods: The study entailed subjecting water samples from Kelantan, Malaysia, to reproduce the natural circumstances that promote the growth of V. cholerae. Subsequently, the samples were contaminated with the V. cholerae O1 El Tor Inaba strain and treated using VPUSM 8. The study employed a controlled experimental design, wherein the samples were divided into three groups, each experiencing different treatment methods. Quantifying the number of colony-
... Show MoreIn order to select the optimal tracking of fast time variation of multipath fast time variation Rayleigh fading channel, this paper focuses on the recursive least-squares (RLS) and Extended recursive least-squares (E-RLS) algorithms and reaches the conclusion that E-RLS is more feasible according to the comparison output of the simulation program from tracking performance and mean square error over five fast time variation of Rayleigh fading channels and more than one time (send/receive) reach to 100 times to make sure from efficiency of these algorithms.
Estimation of mechanical and physical rock properties is an essential issue in applications related to reservoir geomechanics. Carbonate rocks have complex depositional environments and digenetic processes which alter the rock mechanical properties to varying degrees even at a small distance. This study has been conducted on seventeen core plug samples that have been taken from different formations of carbonate reservoirs in the Fauqi oil field (Jeribe, Khasib, and Mishrif formations). While the rock mechanical and petrophysical properties have been measured in the laboratory including the unconfined compressive strength, Young's modulus, bulk density, porosity, compressional and shear -waves, well logs have been used to do a compar
... Show MoreResumen
El presente trabajo nace de una inquietud por la enseñanza del español en Irak a nivel universitario especialmente ante las dificultades que los alumnos árabes en general, e iraquíes en particular, encuentran en su proceso de aprendizaje. Nuestra primera inclinación fue, pues, prestar una atención directa y cercana al alumno como sujeto del aprendizaje, así como a lo que el alumno produce como resultado del mismo. En el presente trabajo pretendemos dotar al estudiante de los conocimientos lingüísticos necesarios para poder interaccionar en una variedad de situaciones y enfrentarse a problemas cotidianos, de manera que desarrolle las destrezas comunicativas que le permitan establecer una co
... Show MoreThe current research aims to :
•know the level of social intelligence of the sample as a whole .
. •taraf statistically significant differences in social intelligence between disadvantaged and
non-disadvantaged peers .
To achieve these objectives, the selected sample of Talbhalmrahlh medium and specifically
students of the second grade average, were chosen randomly stratified's (360) students
included sex (male, female) and (deprived of the Father and the non-deprived) for the
academic year (2013-2014) for the province of Baghdad on both sides (Rusafa-Karkh (
As applied to them measurements of social intelligence, which is prepared by the researcher,
having achieved _khasaúsma of psychometric (valid and re
After a temporary halt to forced thghebr in different cities of Iraq this methodlogy
opeations returned directiy in the areas of political conflict on the ground which are translated
operations and forced displacement violence es they operations aimed at completing the
forced displacement that occurred after the occupation in(2003)which took an upward curve
publicly after these events and some of which are aimed at the liquidation of some provinces
than any demographic diversity of religious or sectarian or alhens and others aimed at
redemographic distribution within the province itself to produce a net sectarian zones as is the
case in Diyala Nineveh and Babylon Baghdad has the epicenter of sectarian violence and th