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.
Background: With the increase in composite material use in posterior teeth, the concerns about the polymerization shrinkage has increased with the concerns about the formation of marginal gaps in the oral cavity environment. New generation of adhesives called universal adhesive have been introduced to the market in order to reduce the technique sensitive bonding procedures to give the advantage of using the bonding system in any etching protocol without compromising the bonding strength. The aim of the study was to study marginal adaptation of two universal adhesives (Single bondâ„¢ Universal and Prime and Bond elect) using 3 etching techniques under thermal cycling aging. Materials and Methods: Forty-eight sound maxillary first premola
... Show MoreAssessing performance efficiency is critical to the management need for oversight, planning, and continuous periodic evaluation of the multiple activities of Northern Cement State Company in order to determine the level of achievement of the objectives set, and to correct the deviations and delays that the evaluation shows and limitation of liability. What cannot be measured cannot be managed. The aim of this research is to highlight the impact of using BSC, financial and non-financial, to give comprehensive and clear picture of the company's performance and to measure the quality of its performance by using six-sigma and the level of deviations in achieving the planned goals. Therefore, four-key hypotheses were formulated for th
... Show MoreThe subject of marketing culture and mental image is one of the important topics in the field of management. There is no study that combines these two variables. The research is important because of the increasing importance of the subject. The future direction of the company in question will support the company's economic and marketing responsibilities. And reflect the company's mental image, as a culture that contributes to changing the reality of the organization investigated by polling the views of a sample of managers in the General Company for Vegetable Oil Industry, which (30) out of the (65) individual, and There are two hypotheses of research: There is a significant
... Show MoreService companies always working to increase their competitiveness and efficiency of the survival, growth and development in the present and the future, including insurance companies, so as to increase competition, especially after the emergence of the civil companies dramatically after 2003, has become the goal of recent studies carried out by the organizations is the human capital, because its success and excellence and achievement its objectives depends on the human, and this does not mean that the other components are not important, but also rely on the rights which has increased interest in the search for the way in which they can guide the behaviors and values and their own language in line with the organization's strategy an
... Show MoreThe aim of the research is to know the effect of a training program based on interactive teaching strategies on achievement and creative problem solving among fourth-grade students in chemistry of the directorate of education Rusafa first, the sample was divided into two groups, one experimental and numbering (29) students and the other control group numbering (30) students. The experimental group underwent the training program in the first semester of the year (2021-2022) and the control one studied according to the usual method. Two tools were built, the first being an academic achievement test consisting of (40) multiple-choice items, and the second a test of creative problem-solving skills in a chemistry subject and consisting o
... Show Morethe digital public relations aim at make the workers getting the necessary information about the governmental institutions where they work and the enveronment surrounding them. it also tries to let the workers get the special knowlege of tthe publich relations and their jobs like the works of planning , arranging the active communication and executive skills needed in their writing , editing , special art skills for designing , production and technological skills to deal with the computer.
the problem of the research includes some questions as :
1- what are the uses achieved by degetal public relations workers at Iraqi universities (Baghdad, Mustansiriya, and Iraqi)
2- what are the tools used to apply digital public relations
Background. The motor response is a fundamental ability that is evident during any physical or motor activity. However, the need for this ability varies from one sport to another and depends on the specific skills required in each sport. Objectives. This study aims to compare the average motor reaction times of the arm and leg among handball, basketball, and volleyball players aged 14 to 16 years. Methods. The sample included 30 players aged 14-16 years from the sports talent care center, evenly distributed on handball, basketball, and volleyball. Standardized tests were used to measure the speed of motor response, including the Batak Micro test for hands, which records the number of responses to light stimuli in 30 seconds, and the Saqer t
... Show MoreA cross-sectional study was conducted on 80 type 2 diabetic patients aged 20-60 years in Baghdad and 20 non diabetic persons as controls. Laboratory assessment of glucose related parameters; Fasting blood sugar (FBS), Glycated hemoglobin (HbA1c), Insulin and Insulin resistance (IR), renal function test; Blood urea, serum creatinine, Calcium (Ca) and Phosphorus (P), Calcium regulating hormones; Parathyroid hormone (PTH), calcitonin and vitamin D, cytokines, Adiponectin and Tumor necrosis factor (TNF-α) and comparison these parameters between patients and controls. The results: a high significant (p˂0.01) increase in FBG level in the patients (211.34 ± 11.20 mg/dl) as compared with control (85.89 ± 3.07 mg/dl). A high significant (p˂0.01
... Show MoreOver application courier company (DHL) to keep the quality of service to achieve customer satisfaction the adoption of precedence delivery time - A prospective study))
Become attention to quality is a global phenomenon, and I took organizations and governments around the world attaches special attention, but we can say that quality has become the first function for many organizations, and has become a management philosophy