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 process of evaluating business processes, complex, repetition of procurement processes, need for raw materials and frequency of demand, which makes dealing with suppliers in the evaluation process, making the need for a process intervention in the process. Lighter on the other hand.
Many Iraqi companies suffer from problems related to suppliers, and cases of administrative and financial corruption are often raised regarding this type of contract and from this reality the necessity of researching this problem and trying to develop some solutions to reduce its impact on the companies' work, by using a method that works according to the standards adopted in Evaluation and selection of the supplier in the
... Show MoreThe current research aims to evaluate the activities and evaluation questions implied in the content of the computer textbook for the fifth preparatory grade according to the creative thinking and developing suggestions through answering the following question: what is the percentage of creative thinking skills in the content of the computer textbook for the fifth Preparatory grade students issued by the Iraqi Ministry of Education/ Directorate General of the curriculum in the academic year (2019-2020)? The researchers followed the descriptive-analytical approach. The research community was determined by the content of the computer textbook for the fifth preparatory grade. As for the research sample, it was limited to all activitie
... Show MoreTransparent nano- coating was prepared by Sol-Gel method from titanium dioxide TiO2 which has the ability to self-cleaning coating used for hospitals, laboratories, and places requiring permanent sterilization. Three primary colors are selected (red, blue, and yellow) as preliminary study to the effect of these colors on the nano-coating. Three traditional oil paints color were used as base, then coated by a layer of TiO2-Sol and deposited on the paints. The optical properties of TiO2-Sol were measured; the maximum absorption wavelength at (λmax=387 nm), the refractive index (n=1.4423) and the energy band gap (Eg=3.2 eV). The structure properties found by X-ray diffraction of TiO
The current study aims to identify the feeling of job alienation and organizational commitment among free lecturers in secondary schools, as well as to identify the significance of the differences in the feeling of job alienation according to the gender and the significance of the differences in organizational commitment according to the gender. It also aims to identify the correlation between the feeling of job alienation and organizational commitment. To achieve the objectives of the research, the researcher developed two scales: one consisted of (24) items to measure the vacancy in job alienation and the other consisted of (24) items to measure the organizational commitment. The two tools were applied to a sample of (200) male and fem
... Show MoreThe current research aims to determine the requirements of Trends of International Mathematics and Science Study (TIMSS 2019) and to find out the extent to which the content of science textbooks for grades (1-4) in the Sultanate of Oman includes the requirements of (TIMSS 2019). Only the content dimension has been taken into account when conducting the content analysis. The study population includes all science books from the first to the fourth grade for the academic year 2021-2022. The study identified and organized the requirements in the study tool, which is a list of requirements of (TIMSS 2019). The results showed a general deficiency in all grades (1-4) in the content dimension including many main topics, subtopics, and objectives
... Show MoreThe aim of the research is to identify the impact of the dimensions of the European Excellence Model in evaluating the performance of the bank of the research sample, as well as to interpret which dimensions are more important to the banks of the research sample. Based on the dimensions of this model, the United Bank for Investment and Finance has chosen a research community, and has met with officials of the United Bank for Investment and Finance at various administrative levels to measure the practices of excellence management in the European model, and the analytical approach has been the case study and the construction of the checklist as a tool to collect information. The research has reached the most important results There is a discr
... Show MoreThe aim of this study is to achieve the best distinguishing function of the variables which have common characteristics to distinguish between the groups in order to identify the situation of the governorates that suffer from the problem of deprivation. This allows the parties concerned and the regulatory authorities to intervene to take corrective measures. The main indicators of the deprivation index included (education, health, infrastructure, housing, protection) were based on 2010 data available in the Central Bureau of Statistics
The use analysis value chain such information in the provision as financial so information quality meet and satisfy the needs of users such information , particularly investors and lenders as the identification needs financial information and the knowledge as their behavior influenced by that information can be based on the accounting profession to focus on improving their function in order to achieve its goal that satisfying their needs and rationalize their decisions . In accounting thought discovered fertile ground for users preferences as one of the entrances theorising positive which is based on the need to include knowledge on accounting hypothesis that explain the
... Show MoreThe ideas and principles formulated by Ibn-Jamaah in the field of education occupy a central place in the historical origins of education for Muslims. These views and principles have an active role in the educational reorganization that the Islamic world aspires to. These ideas have had a great impact on the educational process that had preceded the opinions of Russo, Pestalutzi, Fruel, Herbert, and Dewey. Moreover, we have seen that the Sheikh of Ibn-Jamaah has taken part in formulating the origins of education and leadership.
A checklist of the wild mammals of Syria including their current status and geographical distribution is provided. Data related to 110 mammalian species were collected following a comprehensive review of available literature records, grey data, and online observations combined with photographic evidence and in situ surveys carried out between 2006 and 2023. The checklist comprises seven orders, 36 families, 73 genera (subgenera), and 110 species, and includes data on 15 globally threatened species of wild mammals. Overall, we report up-to-date information on taxonomic revisions, historical and current geographical range, as well as the conservation status recently assessed by the International Union for Conservation of Nature (IUCN)
... Show More