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.
Breast cancer is the most common malignancy in female and the most registered cause of women’s mortality worldwide. BI-RADS 4 breast lesions are associated with an exceptionally high rate of benign breast pathology and breast cancer, so BI-RADS 4 is subdivided into 4A, 4B and 4C to standardize the risk estimation of breast lesions. The aim of the study: to evaluate the correlation between BI-RADS 4 subdivisions 4A, 4B & 4C and the categories of reporting FNA cytology results. A case series study was conducted in the Oncology Teaching Hospital in Baghdad from September 2018 to September 2019. Included patients had suspicious breast findings and given BI-RADS 4 (4A, 4B, or 4C) in the radiological report accordingly. Fine needle aspirati
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Purpose: This research is to identify the most important challenges for the local investment commissions and to develop solutions and proposals to encourage local and foreign investment in local governments in Iraq (the Iraqi provinces are irregular in the region). Theoretical Framework: This research suggests a conceptual framework for the local investment commissions in order to solve their problems, the most important of which was to identify the most critical challenges which are facing the Baghdad Investment Commission BIC and how to overcome them. Design/The methodology approach: Research involved a mixed-methods approach through two stages. During the first stage, the researcher gathered quantitative data from all inves
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The world faced many communication challenges in 2020 after the Covid-19 pandemic, the most important of which was the continuation of schooling. Therefore, the research aimed to analyze the current reality of the studied universities in terms of strengths and weaknesses and measure the implementing level of quality requirements of e-learning. This research studies the impact of knowledge sharing in its dimensions (behavior, organizational culture, work teams, and technology) on the e-learning quality and its dimensions (e-learning management, educational content, evaluation ,and evaluation). After conducting the survey, there was a difference in the universities’ application of the quality requirements of e-learning, as the study
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Hate speech (henceforth HS) has recently spread and become an important issue. This type of speech in children's writings has a particular formulation and specific objectives that the authors intend to convey. Thus, the study aims at examining qualitatively and quantitatively the classism HS and its pragmatic functions via identifying the speech acts used to express classism HS, the implicature instigated as well as impoliteness. Since pragmatics is the study of language in context, which is greatly related to the situations and speaker’s intention, this study depends on pragmatic theoriespeech acts, impoliteness and conversational implicature) to analyze the data which are taken from Katherine Mansfield's short story (The D
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Research Summary :
Praise be to God, Lord of the Worlds, and prayers and peace be upon the Master of the Messengers, his family and all his companions, then after:
This is brief research that contained between its two covers one of the jurisprudence rules derived from Islamic Sharia that guarantees the right of others, in case of forcing to do the prohibited act, and it is a restriction of the rule: “Necessities allow prohibitions” and “Hardship brings facilitation” and support for the rule: “Necessities are valued.” It is an origin in alleviating the taxpayer definitely , and the study has briefly shown some of the jurisprudential appli
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In the midst of rapid changes and difficultiesand the tough competition faced by the Iraqi banks, it has become necessary to focus on a significant aspect of administrative work; that is strategic planning and the key role of implementation within this process in improving the banking service quality. It has emerged as a critical and main competitive weapon for distinguishing the services provided by banks from each other in an effort to participate in increasing market share of the bank in question in question; in its growth, continuation and profit increase.
The research has addressed the relation between the independent variable (implementation within strategic planning), and the dependent variable (banking service quality and
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In this paper Alx Ga1-x As:H films have been prepared by using new deposition method based on combination of flash- thermal evaporation technique. The thickness of our samples was about 300nm. The Al concentration was altered within the 0 x 40.
The results of X- ray diffraction analysis (XRD) confirmed the amorphous structure of all AlXGa1-x As:H films with x 40 and annealing temperature (Ta)<200°C. the temperature dependence of the DC conductivity GDC with various Al content has been measured for AlXGa1-x As:H films.
We have found that the thermal activation energy Ea depends of Al content and Ta, thus the value of Ea were approximately equal to half the value of optical gap.