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 surgeryKeywords: Non-surgical treatment of anal fissure, fissure in ano, sphicterotomy,botulinum toxin in anal fissures, glyceryl trinitrate. Chemical sphincteratomy, pharmacological sphincteratomy.
The study aims to examine the problem of forced displacement and its social and economic problems in light of the Syrian crisis. Such an aim helps to know the difficulties and challenges facing the children of displaced families in learning, and the reasons for their lack of enrolment. It also clarifies whether there are significant statistical differences at among the attitudes of the children of the displaced families towards education regarding the following variables: (the work of the head of the family, the economic level of the family, and the work of the children). The study has adopted the descriptive-analytical approach; a questionnaire was adopted as a tool to collect information. The study was applied to a sample o
... Show MoreAbstract:
Organizations need today to move towards strategic innovation, which means the analysis of positions, especially the challenges faced by the change in the external environment, which makes it imperative for the organization that you reconsider their strategies and orientations and operations, a so-called re-engineering to meet those challenges and pressures. Now this research dilemma intellectual two-dimensional, yet my account in not Take writings and researchers effect strategic innovation in re-engineering business processes, according to science and to inform the researcher, and after the application represented in the non-application of such resear
... Show MoreThe aim of the research is to test the effect of outsourcing human resources activities (independent variable) with its dimensions (outsourcing of staffing, outsourcing of training and development, outsourcing of wages and compensation, outsourcing of human resources information systems) on organizational winning (dependent variable) with its dimensions (the culture of winning, successful organizational change, continuous improvement, and adoption of risk). The research problem was the questions posed by the researcher, the most important of which is the extent to which the research sample realizes the importance of applying outsourcing to human resources activities and its role in organizational vi
... Show MoreVolunteerism is an element included in many human cultures. It represents a positive cooperative act between individuals and groups. It expresses the social value systems. As a social phenomenon, it develops in societies according to innumerous circumstances and conditions. This study uses a functional approach that assumes that volunteering performs six functions for volunteers. Namely, we assume that volunteering (1) creates a sense of protection (2) meets significant cultural values (3) improves professional status of volunteers, (4) strengthens their social relationships, (5) helps them achieve a better understanding of life, and finally, (6) enhances their outlook and self-esteem. The central aim of the study is to discuss these fun
... Show MoreThe research aims to identify the obstacles facing the application of electronic management in our university libraries, including the central library of the University of Baghdad and the central library of Al-Mustansiriya University, the research sample, as they are among the main libraries that used electronic technologies in managing some of their work and in providing their services, and they have a website via the Internet. The research relied on the case study method to identify the obstacles by visiting the two libraries, interviewing their managers and employees responsible for the departments, and answering inquiries about the obstacles that prevent the application of electronic management in order to identify them and find appropr
... Show MorePurpose :This study seeks to provide the point of view stands on the marketing performance of the banks in the context of Dynamic Equilibrium of marketing. It aims to develop a prototype of measuring marketing performance under the umbrella of marketing dynamic prototype, embodied of the strategic alliance and competition, and the laws and legislation, and to explore any of the dimensions more effective in achieving performance. This study aims to discusses the importance of the Dynamic Equilibrium of marketing and it role in achieving the marketing performance <
... Show MoreNews headlines are key elements in spreading news. They are unique texts written in a special language which enables readers understand the overall nature and importance of the topic. However, this special language causes difficulty for readers in understanding the headline. To illuminate this difficulty, it is argued that a pragmatic analysis from a speech act theory perspective is a plausible tool for a headline analysis. The main objective of the study is to pragmatically analyze the most frequently employed types of speech acts in the news headlines covering COVID-19 in Aljazeera English website. To this end, Bach and Harnish's (1979) Taxonomy of Speech Acts has been adopted to analyze the data. Thirty headlines have been collected f
... Show MoreImproved oral bioavailability of lipophilic substances can be achieved using self-emulsifying drug delivery systems. However, because the properties of self-emulsifying are greatly influenced by surfactant amount and type, type of oil used, droplet size, charge, cosolvents, and physiological variables, the synthesis of self-emulsifying is highly complex; consequently, only a small number of excipient self-emulsifying formulations has been developed so far for clinical use. This study reports a highly effective procedure for developing self-emulsifying formulations using a novel approach based on the hydrophilic-lipophilic difference theory. Microemulsion characteristics, such as the constituents and amounts of oil and surfactant electrolyte
... Show MoreThin films of pure tin mono-sulfide SnS and tin mono-sulfide for (1,2,3,4)% fluorine SnS:F with Thicknesses of (0.85 ±0.05) ?m and (0.45±0.05) ?m respectively were prepared by chemical spray pyrolysis technique. the effect of doping of F on structural and optical properties has been studied. X-Ray diffraction analysis showed that the prepared films were polycrystalline with orthorhombic structure. It was found that doping increased the intensity of diffraction peaks. Optical properties of all samples were studied by recording the absorption and transmission spectrum in range of wave lengths (300-900) nm. The optical energy gap for direct forbidden transi
... Show MoreGlobalization has occupied a great deal of studies, research and literature, in addition to being a phenomenon that has imposed itself firmly on the ground. Globalization is considered the main feature of the current moment in today's world. The world is now transforming in an unprecedented way under noticeable titles of successive waves of knowledge and technology.The current research aims to identify the effects of globalization on the variables and their political, social, media and cultural dimensions, as well as culture of consumption and cultural identity.The theoretical framework included two sections: the first is the concept of globalization, its history and its dimensions, and the second is the modernity in contemporary Europea
... Show More