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 electronic payment systems are considered the most important infrastructure for the work of banks, particularly after a steady and remarkable development in information and communication technology, Which created the reality of the work of the infrastructure for these systems and these systems also become one of the most important components of infrastructure for the work of banks, cause it is one of the most important channels through which the transfer of cash, financial instruments between financial institutions in general and banking in particular.
In order to achieve the objectives of the research, the most important to identify the concept of electronic payment systems, and its divisions, and th
... Show MoreThe present study aimed to use the magnetic field and nanotechnology in the field of water purification, which slots offering high efficiency to the possibility of removing biological contaminants such as viruses and bacteria rather than the use of chemical and physical transactions such as chlorine and bromine, and ultraviolet light and boiling and sedimentation and distillation, ozone and others that have a direct negative impact on human safety and the environment. Where they were investigating the presence in water samples under study Coli phages using Single agar layer method and then treated samples positive for phages to three types of magnetic field fixed as follows (North Pole - South Pole - Bipolar) and compare the re
... Show Moreيهدف هذا العمل الى بيان طبيعة العلاقة بين الادارة بالتجوال والتجديد الاستراتيجي ، ومدى تأثير المتغير المستقل في المتغير التابع. تضمنت فقرات الاستبانة بوصفه الأداة الرئيسة لجمع البيانات ثلاث جوانب اساسية، تضمن الاول البيانات الشخصية للمستجيبين، فيما تضمن الجانب الثاني الفقرات الخاصة بمتغير الادارة بالتجوال من خلال خمسة ابعاد، فيما اشتمل الجانب الثالث على فقرات التجديد الاستراتيجي عبر تناول اربعة ابعاد. ي
... Show MoreOrganizations adopt a number of procedures and instructions in their field of activities in order to aid their resources development and energies to serve their entrepreneurial orientations. This calls for preparing a range of mechanisms to mitigate the strictness and complexity of procedures. The ambiguity and severe complexity of procedures means acknowledging the loss in energy and this in turn impedes the hopes while in the same time weakens the enthusiasm in these organizations and an impedes the possibility to achieve continues innovation, thereby losing opportunities to the level of surrender to the risks and assuming them to be unconquered obstacles.
There
... Show MoreThe research problem was to identify the impact of monetary policies on economic growth in the oil and non-oil countries. The researcher chose the Republic of Iraq as an example for the oil countries and the Arab Republic of Egypt as an example for the non-oil countries to hold a comparison on the impact of monetary policies.
The research found that the monetary policies and their tools in the Iraqi economy affect the rate of GDP growth by 73%, which shows the strong impact of monetary policies on the economic growth in the Iraqi economy as an example of an oil state. GDP growth rate of 61%, indicating the impact of monetary policies on economic growth in the
RKRAS L. K. Abdul Karem, F. H. Ganim, Biochemical and Cellular Archives, 2018 - Cited by 2
ABSTRACT : This research involves the synthesis of five to seven heterocyclic compounds starting with Schiff’s bases which derived from oxime as a starting material. 1.3-oxazepine derivatives were prepared from adding different anhydrides to the Schiff bases, tetrazole and thiazolidinone derivatives synthesized from add sodium azide and thioglycolic acid to the same Schiff’s bases as a five members ring. Pyrimidine derivatives were prepared after the reaction of the azomethine group with acetyl chloride and then urea and thiourea to synthesis on derivatives contain the six members ring. Another step included identified and confirmed these compounds by FT- IR, 1HNMR, TLC and 13CNMR finally, step included the assay of biological activity
... Show MoreThis research investigates the importance of social accounting and the auditor’s report. It basically checks if there is an impact of social accounting on the auditor’s report at the availability the INTOSAI standards No. (1700 and 1706). The study recruited 105 employees of the Federal Financial Supervision Office in Iraq. Data were collected using questionnaire. The questionnaire validity and reliability were checked to assure the truthfulness of the findings. The study found a positive correlation and a statistically significant effect between the accounting for social responsibility and the auditor’s report. It is necessarily recommended for the auditor and the bodies working in the Board of Supreme Audit to ensure the inclusio
... Show MoreThe goal of this research is to find the effects of both the studying students groupwhich has various educational levels and the integration of the fragmented information through or during the study of history subjects for the female students of the fifth secondary literary section.
To achieve this study or case the researcher has chosen an experimental design or test by studying three groups: two are as mentioned above and the third is just ordinary team. In addition to that, there is a test after the experiment. The researcher chose on purpose female students of the literal section from two different secondary school Al Asil and Wahran both are secondary school for girls, and both are from directorate of education- Al Karkh 2nd dist
The present paper is very important for study of biodiversity of Iraq , to know how the
changes going and how the laughing dove S. senegalensis was a rare species in Iraq and now
is common and also the (baz) gosh hawk A. gentilis is common and the most famous 6rd of
pray in Iraq, till now missing from ornithologist and bird watcher to record it