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.
Is a high degree of economic freedom an important part in the development of the economies of developing countries in the last decade of the twentieth century and the beginning of the twentieth century and the atheist. This is because a test subject (deltoid analysis of the relationship between the degree of economic freedom and foreign trade of selected developing countries for the period
( 1990 -2005) to determine the degree of economic freedom in foreign trade promotion in Singapore and Turkey. The research recommends a number of recommendations, the most important is the responsibility of the Ministry of Planning in Iraq that is providing the necessary data for the Fraser Institute, the aim of increasing cooperation
This research is a comparative jurisprudential study that focuses on Imam Al-Bayhaqi’s preferred opinions in his book Al-Khilafiyat (The Disagreements), the part of Al-Rida’a (Breastfeeding). It is considered one of the most important familial topics that is concerned with organizing the social relations in Islam, strengthens the family ties and that prevents the family disintegration due to the ignorance and lack in comprehending Sharia laws (Islam law) in all aspects. The study follows the inductive and descriptive method. It aims at examining the prohibition of marriage when breastfeeding takes place at the time of woman’s conversion to Islam or during her infidelity period. It further aims at verifying the prohibition
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This study focuses on studying the effect of reinforced steel in detail, and steel reinforcement (tensile ratio, compression ratio, size, and joint angle shape) on the strength of reinforced concrete (compressive strength) Fc' and searching for the most accurate details of concrete divisions, their behavior, and corner resistance of reinforced concrete joint. The comparison of this paper with previous studies, especially in the studied properties. The conclusions of the chapter are summarized that these effects had a clear effect and a specific effect on the behavior and resistance of the reinforced concrete corner joints under the negative moments and under their influence and the resulting stress conditions. The types of defects that can
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The added value of internal audit greatly contributes to adding value to the institution, but most departments of economic units in Iraq neglected the role of internal audit and the added value that can be achieved by those institutions, since the term added value of internal audit is a relatively vague term from the premise that what cannot be measured is difficult Determine it, and perhaps descriptive standards for it is the extent of compliance with international auditing standards (IIA).
The research aims to study the procedures and results of auditing to verify that they have given an added value to the audit with a positive impact, develop its aspects and research, identify deficiencies for the audi
... Show MoreThis study is due to insufficient development of the issues of initial training in tennis at youthful (student) age. Objective: development of a methodological and scientific-methodological base of students' tennis with current trends in tennis. Summing up the best practices of modern tennis, we came to the conclusion that the formation of the art of reflection backhands in teaching beginner students of sports specialization to achieve future success. In modern conditions in the development of Russian tennis student opens the possibility of using new technologies and programs. Using these approaches, we have developed a training program and tested students' tennis in the pedagogical experiment, which resulted in its effectiveness.
In this paper we prove the boundedness of the solutions and their derivatives of the second order ordinary differential equation x ?+f(x) x ?+g(x)=u(t), under certain conditions on f,g and u. Our results are generalization of those given in [1].
Objective(s):To evaluate the quality of life among secondary and to find out the relationship between students'quality of life and their socio-demographic characteristics of age, gender, residence, marital status, father's and mother's education, and family financial status in Kirkuk City. Methodology: A cross-sectional study is conducted on (100) studentwho are boys and girls aged(13 to 24) years old. These subjects are studying at secondary schools in Kirkuk City.The study is carried out at secondary schools in Kirkuk City from 7th July 7th 2014 to May 7th 2015. A questionnaire is constructed for the purpose
The orbital motion and longitude for some Jupiter's satellites (Amaletha, Europa, Ganymede and Callisto) were calculated from two different locations Iraq and Syria. A program was designed, the input parameters were the desired year, month, day and the longitude of the location, the output parameters results were applied in form of a file, and this file includes the longitude, orbital motion, and local time of these satellites. A specific date 1-10-2013 was taken, the results of longitude was (20-336) º and orbital motion was (92-331) º for both Iraq and Syria location with observing time (05:24:14-15:18:10) for Iraq and (04:56:33-14:50:30) for Syria. The difference in time between the two locations was constant (00:45:00), these results
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The research aims to define the theoretical framework for corporate governance and its mechanisms and shed light on corporate governance in Iraq as well as the theoretical framework for the quality of financial reports and their relationship and the role of corporate governance in activating them. A commercial bank as a sample for the research, and a survey list was prepared to show the extent to which the research sample banks are committed to applying internal governance mechanisms. imposed on them by the local environment, which leads to improving the quality of financial reports for these banks.
يحتل موضوع الاستهلاك اهمية كبيرة في الدراسات الاقتصادية في حالتي السلم والحرب وذلك لارتباط هذا الموضوع بالانسان والمجتمع ولكونه احد مؤشرات مستوى الرفاهية الاقتصادية والاجتماعية وتزداد اهمية ضبط حركة هذا المتغير السلوكي والكمي في زمن الحرب اكثر مما هو عليه في حالة السلم، في هذا البحث تم استخدام بيانات احصائية عن الانفاق الاستهلاكي الخاص ونصيب الفرد من الدخل القومي اضافة الى الرقم القياسي لاسعار المس
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