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 Incentives legislation aims to raise the efficiency of job performance of all kinds through optimal investment of human resources and their capabilities to raise or increase and production influence and provide distinguished and creative services such as The Incentives Law of Productive Ministries Employees No. 20 of 1993 and instructions issued by ministries and relevant Facilities regarding incentives for their affiliates based on provisions Public Companies Law and the instructions of the Higher Education Fund issued by the Ministry of Higher Education and Scientific Research. The human element is the most unstable and complex element of production as it is characterized by a set of feelings and emotions that is expresses
... Show More
(22)
(15)
In this work, the adsorption of crystal violet dye from aqueous solution on charcoal and rice husk has been investigated, where the impact of variable factors (contact time; the dosage of adsorbent, pH, temperature, and ionic strength) have been studied. It has been found that charcoal and rice husk have an appropriate adsorption limit with regards to the expulsion of crystal violet dye from fluid arrangements. The harmony adsorption is for all intents and purposes accomplished in 45 min for charcoal and 60 min for rice husk. The amount of crystal violet dye adsorbed (0.4 g of charcoal and 0.5 g of rice husk) increased with an increasing pH and the value of 11 is the best
... Show More
(6)
(2)
The research aims to identify the risks faced by projects and work on the administration, such as those risks by using professional Project Management System (Project Management Professional) by identifying those risks and their impact on the objectives of the project, if they occur and to provide appropriate responses to Ha.autam search application on the draft Law Faculty port by the General Mansour Construction Contracting company has been using a method personal interview with the heads of departments and project managers in the Al-Mansour and tools descriptive and quantitative analysis as was used (likelihood and impact of risk analysis, Ai_kaoa scheme Sbb- effect, analysis of probability and impact, risk matrix (probability
... Show More
Back ground: Skin grafting is the most common form
of reconstructive surgery, and regeneration of
sensations in skin grafts is a complex process
influenced by many factors such as , the thickness of
the graft, the depth of the grafted bed, meshing of the
graft, the condition of the bed and the surrounding
area. So many studies performed on this subject, some
of them clinically based on subjective type of sensation
tests, and others histological to detect the presence of
nerve fibers in the grafted skin
Objectives: To detect return of sensations to split
thickness skin grafts by clinical methods.
Methods: From Oct. 1995 to Oct. 2010, a clinical
prospective study performed in Al wasity Hospital for
Background: During pregnancy many physiological, anatomical and biochemical changes take place that affect almost all body systems. In the oral pregnant women have serious changes such as more sever dental caries. This study was conducted to measure dental caries severity and selected salivary variables (salivary flow rate, PH and viscosity)and to find the relation of dental caries with these salivary variables. Subjects, materials and methods: The study group consisted of 60 pregnant women that were divided into three equal groups according to trimester (20 pregnant women in each trimester).They were selected randomly from the Maternal and Child Health Care Centers in Baghdad city, the age range was 20-25 years. In addition to 20 unmarried
... Show More
(3)
The present study aims to detection optimal conditions of production of amylase enzyme from isolate of B. subtillis A4. Nine carbonic sources were represented by starch, maltose, fructose, sucrose, glucose, arabinose, xylose, sorbitol and mannitol) at concentration of 1% for each source. It was found that the best was represented by starch carbonic, which showed higher activity and qualitative activity of 7.647 Unit/ ml and 461.56 Unit/ mg. Ten nitrogen sources were selected, including yeast extract, peptone, trypton, gelatin, urea and meat extract as organic sources Ammonium sulphate, Sodium nitrate, Potassium nitrate and Ammonium chloride as inorganic sources. These sources were added at aconcentration of 0.5% to the production medium. Th
... Show More
(2)
In view of the large profits made by the sex trade on the one hand, and the minor penalties imposed on the traffickers (brokers) compared with the severe penalties imposed on the drug trade and illegal weapons, on the other hand, this trade has become popular and spread in most countries of the world, and the cornerstones of this trade and A safe haven for them is hotels, especially luxury ones with international brands where their guests are rich and some may look for sex for money. Given the great physical and psychological damage to the victims, this research highlights the civil liability of hotels towards these victims in US and Iraqi law.In order not to limit the
... Show More
(9)