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.
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This current research deals with the "The role of organizational change in the achievement of strategic success" Who are getting increased attention to being one of the important topics and relatively new, And which have a significant impact on the future of the organization So there is a need for this research, which aims to identify the role of organizational change across dimensions (technology, organizational structure, human resources, organizational culture) in the strategic success through its components (a specific strategy, effective implementation, innovation, customer satisfaction)، And that by two main hypotheses, branched about eight hypothes
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تعد لعبة كرة السلة من الألعاب الرياضية التي تحتاج متطلبات بدنية ووظيفية خاصة بها، وذلك من خلال الانتقال داخل الملعب بالكرة أو بدونها والسبل للتخلص من ملاحقة الخصم أثناء الدفاع وكيفية المناورة أثناء الهجوم مع إجادة التصويب بكافة أنواعه داخل الملعب، ومن هنا تكونت مشكلة البحث في كيفية تطوير تلك العوامل الوظيفية والتي لها الأثر في الارتقاء بمستوى أداء اللاعب أثناء اللعب، وعن طريق استخدام الباحثان لطريقة جهاز ا
... Show MoreBackground: Postoperative pain is one of the main complications following impacted mandibular third molar (IMTM) surgery. Objectives: The aim of this study was to assess the effect of the local application of bupivacaine on reducing early postoperative pain following IMTM surgery. Material and methods: A prospective, single-blinded, randomized controlled study was conducted on 40 patients who had undergone the surgical removal of an IMTM under local anesthesia. In the study group (n = 20), absorbable gelatin sponge (AGS) soaked in 3 mL of 0.5% plain bupivacaine hydrochloride was locally applied in the post-extraction socket. In the control group (n = 20), AGS soaked in 3 mL of normal saline was used. Pain intensity was assessed using a pa
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Acute lymphoblastic leukemia (ALL) is a cancer of the blood and bone marrow (spongy tissue in the center of bone). In ALL, too many bone marrow stem cells develop into a type of white blood cell called lymphocytes. These abnormal lymphocytes are not able to fight infection very well. The aim of this study was to investigate possible links between E3 SUMO-Protein Ligase NSE2 [NSMCE2] and increase DNA damage in the childhood patients with Acute lymphoblastic leukemia (ALL). Laboratory investigations including hemoglobin(Hb) ,white blood cell (WBC) , serum total protein , albumin ,globulin , in addition to serum total antioxidant activity (TAA) , Advanced oxidation protein products(AOPP) and E3 SUMO-Protein Ligase NSE2[NSMCE2]. Blood samples
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The use of the Iraqi song in the symphony orchestra is one of the pioneering and important works, which carries with it an artistic value of aesthetic specificity in how to use the Iraqi singing heritage. The research aimed to identify the employment of the song (Foug Al-Nakhl) and its works within the Iraqi national symphony orchestra music by the author Hans Count Momer whose works still have a great influence on the authors of the Iraqi orchestra. The researcher presented a brief introduction to the Iraqi Symphony Orchestra, a brief introduction about the author, and the trends of world music towards heritage. He also talked about musical composition, research procedures and tools, and applying the tool to the selected sample (F
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Can not reach a comprehensive concept for interior design through the use of Harmonization term according transformations experienced by the terms of the variables associated with the backlog of cultures that characterize concepts according to the nature of the users of the spaces in the design output, which necessitates the meaning of the combination of knowledge, art, science, such as the type of perceptions design the Harmonization cognitive science with art to create products of the use of design configurations that help the designer to put such a product within the reality and like the fact that reliable, as well as the rational knowledge tend somehow to the objective specifically in facilitating the substance subject to perceptible
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The exchange rate is of great importance at the global and local levels alike, as this importance increases with the increasing rates of development of economic relations between countries of the world due to openness and integration into the global economy, expressed by the expansion of the volume of trade and financial relations between countries. The Central Bank of Iraq has set the need to stabilize this price as a goal to reduce inflation rates and reduce them to the internationally accepted rates by using the foreign currency sale window to achieve a balance between the forces of supply and demand for foreign currency and to preserve the value of the Iraqi dinar. The research concluded that the central bank was It has a maj
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Abstract
Business organizations are using the technological innovations like cloud computing (CC) as a developmental platform in order to improve the performance of their information systems. In that context, our paper discusses know-how in employing the public and private CC to serve as platforms to develop the evaluation system of annual employees' performance (ESAEP) at Iraqi universities. Therefore, we ask the paper question which is “Is it possible to adopt the innovative solutions of ICTs (Like: public and private CC) for finding the developmental vision about management information systems at business organizations?”. In addition, the paper aim
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