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 current research aims to study the extent to which the Independent High Electoral Commission applies to information security risk management by the international standard (ISO / IEC27005) in terms of policies, administrative and technical procedures, and techniques used in managing information security risks, based on the opinions of experts in the sector who occupy positions (General Manager The directorate, department heads and their agents, project managers, heads of divisions, and those authorized to access systems and software). The importance of the research comes by giving a clear picture of the field of information security risk management in the organization in question because of its significant role in identifying risks and s
... Show MoreThis study found that one of the constructive, necessary, beneficial, most effective, and cost-effective ways to meet the great challenge of rising energy prices is to develop and improve energy quality and efficiency. The process of improving the quality of energy and its means has been carried out in many buildings and around the world. It was found that the thermal insulation process in buildings and educational facilities has become the primary tool for improving energy efficiency, enabling us to improve and develop the internal thermal environment quality processes recommended for users (student - teacher). An excellent and essential empirical study has been conducted to calculate the fundamental values of the
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The current research aims at highlighting the role of engagement of a sample of employees who works in some of the Iraqi private banks in terms of their interaction , commitment and enthusiasm and the positive impact they own regarding their job and devote their efforts to achieve the core purpose which is customer loyalty. The problem was expressed through a number of intellectual and practical questions.
In order to achieve the aim of the research the quantitative analytical method was used depending on a questionnaire as a basic tool to collect research data and the qualitative survey method depending on semi-structured interviews which were distrib
... Show MoreEuphemisms are advantageous in people’s social life by turning sensitive into a more acceptable ones so that resentful feelings and embarrassment can be avoided. This study investigates the ability of Iraqi English learners in using euphemistic expressions, meanwhile, raising their awareness and the faculty members in English teaching faculties regarding the relevance of discussing the topics that demand euphemisation. This study comprised three stages: initial test, explicit instruction with activities, and a final test for the students’ development in this domain. A test has been distributed among 50 respondents, who are at the fourth year of their undergraduate study at the University of Babylon/ College of Basic Education. The lo
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Statistical control charts are widely used in industry for process and measurement control . in this paper we study the use of markov chain approach in calculating the average run length (ARL) of cumulative sum (Cusum) control chart for defect the shifts in the mean of process , and exponentially weighted moving average (EWMA) control charts for defect the shifts for process mean and , the standard deviation . Also ,we used the EWMA charts based on the logarithm of the sample variance for monitoring a process standard deviation when the observations (products are selected from al_mamun factory ) are identically and independently distributed (iid) from normal distribution in continuous manufacturing .
This study aims to identify the anxiety pregnant women have of dying, in the light of some Demographic variables in Bethlehem (age, residence, and the mother's job). The descriptive method was used in this study. To achieve the study purposes, the researchers developed a questionnaire as a tool of study, which consisted of (19) paragraphs ,after been verified of its validity & stability.
The researchers distributed questionnaires, and then analyzed them. Results illustrated that the levels of anxiety pregnant women in Bethlehem had of dying was average, with a mean total score of (3.11), and with a standard deviation that had the total score of (0.476). Results also illustrated statistical differences in the pregn
... Show MoreThe language that consists of only twenty-eight letters, but it is so broad that we are unable to understand it from all sides and this expansion is mainly caused by imagination, so Arab imagination, whose language goes in all directions And as it always responds to our ears, ancient critics divide imagination into holistic and partial But the language is not limited to these parts only. Do we wonder, where is the structural method of wishing, hope, questions and other methods of all this? In this paper, we try to show the importance of the method of writing in moving imagination in an interactive way, and what is related to human feelings in most, if not all, of its methods By studying the poetry of the believers in the Ahl al-Bayt, pea
... Show MoreThe novel Vierordt’s approach, or simultaneous equation method, was created and validated for the concurrent determination of vincristine sulfate (VCS) and bovine serum albumin (BSA) in pure solutions utilizing UV spectrophotometry. It is simple, precise, economical, rapid, reliable, and accurate. This method depends on measuring absorbance at two wavelengths, 296 nm and 278 nm, which correspond to the λmax of VCS and BSA in deionized water, respectively. The calibration curves of VCS and BSA are linear at concentration ranges of 10–60 μg/mL and 200–1600 μg/mL, with correlation coefficient values (R2) of 1 and 0.999, respectively. The limits of detection (LOD) and quantification (LO
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