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 aim of the research is to explain the nature of the relationship between the dimensions of the strategic recovery of the service represented by (compensation, speed of response, apology, initiative (defining the problem) and the strategic goals of the company represented in (profitability, growth, community service, employee satisfaction) in the National Insurance Company, it has been approved The questionnaire as a tool to collect data and information from the sample of (58) who are in (department manager, M. department director, division official, unit official) and the statistical program (spss) was used in calculating (arithmetic mean, standard deviation, coefficient of variation, coefficient of Correlation, t-test, varia
... Show MoreIn this work the effect of annealing temperature on the structure and the electrical properties of Bi thin films was studied, the Bi films were deposited on glass substrates at room temperature by thermal evaporation technique with thickness (0.4 µm) and rate of deposition equal to 6.66Å/sec, all samples are annealed in a vacuum for one hour. The X-ray diffraction analysis shows that the prepared samples are polycrystalline and it exhibits hexagonal structure. The electrical properties of these films were studied with different annealing temperatures, the d.c conductivity for films decreases from 16.42 ? 10-2 at 343K to 10.11?10-2 (?.cm)-1 at 363K. The electrical activation energies Ea1 and Ea2 increase from 0.031 to 0.049eV and
... Show MoreMany countries are very important in their interest not only in diversifying foreign reserves, but in determining and planning their volume in accordance with the goals set, namely facing potential external shocks, as the research aims to determine the extent of the strength of foreign reserves in the possession of the Central Bank in relation to every influential variable in the Iraqi economy. , in order to determine the minimum level of reserves that requires reconsideration of the exchange rate, as the research adopted the inductive analytical method in analyzing real (Quantitative data) for the research variables in the years of study, as the research adopted a set of analytical indicators approved by the International Moneta
... Show MoreValues are penetrating or interfering in the lives of individuals and groups and are connected to them in the sense of life itself, because they are closely linked to the motives of behavior, hopes and goals, and can be said that values are everything. The concept of values is one of the concepts that have received the attention of researchers from different disciplines. This has resulted in a kind of confusion and variation in use from one specialization to the other, and uses multiple uses within one specialization. Therefore, there is no uniform definition of values because they relate to individuals. Individuals differ in many things, such as perception,
... Show MoreThe current research aims to verify the role of strategic intelligence as an explanatory variable in organizational success as a respondent variable in the colleges of the University of Fallujah, the research community. (Dean, Associate Dean, Section Head, Division Officer, Unit Officer), The researcher used the questionnaire as the main tool to collect data that included (50) items, in addition to using personal interviews and field observations as aids in data collection. The researcher relied on statistical programs (SPSS V.25; Excel V (16) In the treatment and analysis of data through the use of the most appropriate statistical methods (arithmetic mean, standard deviation, difference coefficient, determinatio
... Show MoreThis work includes two steps of synthesis, the first one is the synthesis of indole which was prepared according to literature of the reaction of phenyl hydrazine with acetaldehyde in glacial acetic acid afforded phenyl hydrazone of acetaldehyde , this product was fused with zinc chloride to give the indole.Reaction of cyclohexanone with phenyl hydrazine using the same procedure for the preparing giving 1,2,3,4-Tetrahydrocarbazole.Second step involved synthesis of a series of (17) of mannich bases derivatives of indole and 1,2,3,4-Tetrahydrocarbazle. Mannich reaction involves the condensation of aldehyde usually formaldehyde with different secondary amine and with compound containing an activated hydrogen.The reaction illustrated by the fo
... Show MoreThin films of cadmium sulphoselenide (CdSSe) have been prepared by a thermal evaporation method on glass substrate, and with pressure of 4x10-5 mbar. The optical constants such as (refractive index n, dielectric constant ?i,r and Extinction coefficient ?) of the deposition films were obtained from the analysis of the experimental recorded transmittance spectral data. The optical band gap of (CdSSe) films is calculate from (?h?)2 vs. photon energy curve. CdSSe films have a direct energy gap, and the values of the energy gap were found to increase when increasing annealing temperature. The band gap of the films varies from 1.68 – 2.39 eV.
A taxonomic keys was established of book and bark lice Order Psocoptera to isolated insects in Iraq from different localities of Baghdad and Babylon provinces. Thirteen species belong to eight genera and five families have been studied and described in details, these species were recorded for the first time in Iraq. These species are: Belaphopsocus badonneli New, 1971; Belaphotroctes oculeris Bodonnel, 1973; Embodopsocosis newi Bodonnel, 1973; Epipsocus stigamaticus Mockeord, 1991; Lepinotus huoni Schmidt and New, 2008; Liposcelies decolor Peramane 1925 Liposcelies paeta Pearman 1942 Liposclies bostrychphila Badonnel 1931; Liposclies brunnea Mostchulsky 1852; Liposclies entoophila Enderlein 1907; Neopsocopsis minuscule Li 2002 ;
... Show Moreتعد الموازنة الأداة الأساسية لتنفيذ أولويات أية دولة، ويتوجب النظر إليها في ضوء المناخ الاجتماعي والسياسي والاقتصادي، لأنها تساعد في توجيه الاقتصاد لتحقيق النمو ورفع مستوى الرفاهية. اعتمدت وزارة المالية في أعداد الموازنة السنوية بعد 9/4/ 2003 أسلوباً مغايراً لما كان معتمداً في العقود الماضية، إذ كانت هناك موازنتين الأولى الموازنة الجارية، والثانية الموازنة الاستثمارية رغم وجود قانون يحتم إصدار موازنة
... Show MoreIn the recent decade, injection of nanoparticles (NPs) into underground formation as liquid nanodispersions has been suggested as a smart alternative for conventional methods in tertiary oil recovery projects from mature oil reservoirs. Such reservoirs, however, are strong candidates for carbon geo-sequestration (CGS) projects, and the presence of nanoparticles (NPs) after nanofluid-flooding can add more complexity to carbon geo-storage projects. Despite studies investigating CO2 injection and nanofluid-flooding for EOR projects, no information was reported about the potential synergistic effects of CO2 and NPs on enhanced oil recovery (EOR) and CGS concerning the interfacial tension (γ) of CO2-oil system. This study thus extensively inves
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