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 research dealt with the effect of the tax examiner's efficiency in detecting tax evasion, as the research problem dealt with tax evasion, especially in Iraq, for many reasons and factors, including those related to tax administration represented in administrative corruption and the complexity of procedures in the tax accounting process and failure to achieve justice in the tax treatment, including the taxpayer himself, as he tries to evade for reasons Related to the level of tax awareness, loss of confidence in the tax administration, and reasons related to the state's inability to manage the services file well and its ability to achieve the set goals, This reflected negatively on the emergence of some of the consequences of
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The aim of this research is to highlight the importance of achieving customer satisfaction by using information technology and Internet networks in the process of purchasing flight tickets, and switching from the traditional method of purchasing and payment operations to the electronic method, to reduce the financial and non-financial risks associated with the traditional purchasing process, as well as saving time, effort and costs for the customer. The researcher used the deductive approach in linking the variables (achieving customer satisfaction and Internet of Things technology for booking electronic tickets)
... Show MoreThe purpose of this resesrh know (the effectiveness of cooperative lerarning implementation of floral material for calligraphy and ornamentation) To achieve the aim of the research scholar put the two zeros hypotheses: in light of the findings of the present research the researcher concluded a number of conclusions, including: -
1 - Sum strategy helps the learner to be positive in all the information and regulations, monitoring and evaluation during the learning process.
2 - This strategy helps the learner to use information and knowledge and their use in various educational positions, and to achieve better education to increase its ability to develop thinking skills and positive trends towards the article.
In light of this, the
The research deals with one of the urban problems facing cities, namely the existence of neglected urban spaces that need to be activated , These spaces give a negative image of the city, is not conducive to life and social interactions or the city has a one distinctive urban experience, leading to a reduction peoples' confidence in revisiting of those areas, hinder the rest of the activities in that region . Because these spaces are of the basic components of the city and give it its identity through the elements and entities that constitute it , The idea of research emerged in the reclaiming of these spaces within contemporary urban trends and the activation of flexible , short-term and inovation for that purpose with
... Show MoreThis research seeks to attempt to reveal the intention of Al-Hafiz Al-Mazi from his market to hadiths from Imam Ahmad’s Musnad in his book “Masterpiece of Supervision in Knowing the Parties”, and researchers know that this book was classified by Al-Mazi to collect the parties to the six books: Sahih Al-Bukhari, Sahih Muslim, Sunan Abi Dawud, Jamea Al-Tirmidhi and Sunan Al-Nasa’i and Sunan Ibn Majah, in addition to some of the books ’authors’ books, and arranging them according to the Musnad, and it is not Musnad Ahmad from his condition, even if it is close to the arrangement of Mazi’s work, as he was a follower of that to the original owner Abu al-Qasim bin Asaker in his book “Supervising Knowledge of the Parties” in M
... Show MoreObjectives: This study aims to assess the quality of life of cerebral palsy children less than 12 years old reported by
parents in Erbil city/Iraq.
Methodology: A descriptive study was conducted during 2014, to describe the quality of life of cerebral palsy
children. One hundred mothers have cerebral palsy children were participated in this study. The study took place at
Helena Center for handicapped children in Erbil City. Questionnaire was used to collect data, which consists of two
main parts. The first part is divided into two sections; section one was described the mothers’ demographic
characteristics, while the second section was for identifying the demographical characteristics of cerebral palsy
children. Th
As they are the smallest functional parts of the muscle, motor units (MUs) are considered as the basic building blocks of the neuromuscular system. Monitoring MU recruitment, de-recruitment, and firing rate (by either invasive or surface techniques) leads to the understanding of motor control strategies and of their pathological alterations. EMG signal decomposition is the process of identification and classification of individual motor unit action potentials (MUAPs) in the interference pattern detected with either intramuscular or surface electrodes. Signal processing techniques were used in EMG signal decomposition to understand fundamental and physiological issues. Many techniques have been developed to decompose intramuscularly detec
... Show MoreThe marketing logistic chain, as an integrated system aimed to balance the achievement of its main opposite objectives which represented in the access to the best service presented to the customer with lowest possible logistic costs especially the transportation costs, where encourages the researcher to choose the second objective as a field of this study in order to reduce the transportation costs in the final link of marketing logistic chain which related to delivering of fuel oil to the customer that falls within organizational responsibilities of the company under consideration (Oil Marketing Company) and also known in a brief name by (SOMO) through two methods, the first is by functioning quantative techniques by using trans
... Show MoreWhereas conventional methods of teaching history do not meet the sometimes purpose has suggested some educators strategies modern help to improve the level of students in the education process through activating prior knowledge and employed in positions of current learning, and focus attention on the points and the outstanding elements of the content and practice techniques Calendar criticof ideas and meanings and mental and linguistic activities used to verify the extent of reaching understanding. &n
... Show MoreSlag of aluminum is a residue which results during the melting process of primary and secondary aluminum production. Salt slag of aluminum is hazardous solid waste according to the European Catalogue for Hazardous Wastes. Hence, recovery of aluminum not only saves the environment, but also has advantages of financial and economic returns. In this research, aluminum was recovered and purified from the industrial wastes generated as waste from both of State Company for Electrical and Electronic Industries (Baghdad/AlWaziriya) and General Company for Mechanical Industries (Babylon/-Al-Escandria). It was found that these wastes contain tiny proportions of other elements such as iron, copper, nickel, titanium, lead, and potassium. Wastes were
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