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.
Tax governance is a set of legal means that directs the tax administration to deal in good faith with taxpayers based on transparency, integrity and accountability while ensuring the achievement of tax justice and works to introduce advanced means by which it deals with all stakeholders.
In this study, we try to explain its rooting and legal nature by shedding light on the position of some international organizations and their internal legislation in the context of public finance.
Agricultural lands have great importance in people's lives, and their exploitation has a great impact on strengthening the national economy. Therefore, countries have given great importance to this sector, and because of the importance of this sector, the state has given large areas of these lands to the farmers to invest in agriculture, and among these farmers are those who died and left behind children who took up crafts. Agriculture, for fear that these agricultural lands would be abandoned and turned into waste lands, a land system was introduced called (regular distribu- tion), which corresponds to (legitimate inheritance). Under this system, these lands were trans- ferred to the children of farmers who died so that the process of inve
... Show MoreSeasonal variations of the species composition and abundance of Cladocera were studied in two stations at the end of the Tigris River and one station at the confluence of the Tigris with Euphrates area, at the beginning of the Shatt Al-Arab River in Al-Qurnah North of Basrah Province, from October 2015 to August 2016. Samples of zooplankton were collected by plankton net 100-µm. mesh size. The population density of Cladocera ranged between 1 Ind /m³ during summer and 211 Ind./m³ during winter at station 1 (Al-Jewaber Bridge). A total of 16 species of Cladocera belonging to 12 genera were recorded in the study. The average density of Cladocera ranged from 23.2 ind./m3 at Station 2 (Hamayon Bridge) to 53.7 Ind./m3
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Abstract
This research’s goal is to restore and to revive the jurisprudence of Mother of Believers (Um alMuaamineen) “Um Salmah” "may God bless her", and to highlight her outstanding assimilation and understanding of religion and her conscious thought. The current research is a comparative scientific theoretical study represented in the comparison of jurisprudence of “Um Salamah” with Hadiths of fasting and pilgrimage rules as well as the duration mentioned in jurisprudence of for doctrines( 4 schools of thought )to identify these hadiths with the inclusion and discussion of their evidence.
The current research included two topics: the first one is to identify and introduce
... Show MoreThe banking sector of all kinds is the backbone of the economy in all countries, as it is the main financier of most economic projects in order to achieve economic development and achieve stability, which contributes to providing the necessary resources in return for obtaining a profit margin in exchange for giving up his money and bearing credit risks. Among the aforementioned banking sectors are: Islamic banks that invest their capital in several forms in order to obtain profits that enable them to continue and grow, and the most important of these formulas is the Murabaha formula, which is summarized by the bank selling a commodity after owning it and then selling it to the applicant for this commodity based on a prior request
... Show MoreWith a descriptive and analytical approach, it discusses the concept of phenomenology as an approach to seeing the aesthetics of ugliness as one of the concepts associated with the aesthetic experience in contemporary art designs, as it is the result of communication between artistic production and the recipient, which leads to creating a state of aesthetic pleasure. A phenomenological method is used to uncover the aesthetics of ugly and to connect ugliness and beauty since ugliness in aesthetics incorporates beauty as a modern aesthetic vision from the phenomenological perspective. The study investigated aesthetics as a phenomenon of perception, sensory knowledge, and the aesthetic response to the production of designs in contemporary a
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The Boltzmann transport equation is solved by using two- terms approximation for pure gases . This method of solution is used to calculate the electron energy distribution function and electric transport parameters were evaluated in the range of E/N varying from . 172152110./510.VcmENVcm
From the results we can conclude that the electron energy distribution function of CF4 gas is nearly Maxwellian at (1,2)Td, and when E/N increase the distribution function is non Maxwellian. Behavior of electrons transport parameters is nearly from the experimental results in references. The drift velocity of electron in carbon tetraflouride is large compared with other gases
Objective: The study aim to evaluate of women's knowledge and personal preference about the place
of delivery in Baghdad City
Methodology:
descriptive study conducted in baghdad city on the mothers for the period from the 14th of December,
2015 to the 14th of April 2016. The sample of study included 500 mothers who were attending to
primary health care centers have been chosen sample of 26 primary health care center by a multi-stage
Simple random sampling Data was collected through a constructed questionnaire, validity Data was
analyzed by using of descriptive and inferential data analysis methods .
Results: The results indicated that approximately (29.4%) of the mothers in the age group (20-24) and
the average
The settlement rate and pore water pressure dissipation rate are mainly controlled by the permeability of soil. Both laboratory and field tests show that the permeability is varied during the loading and consolidation process. It is known that consolidation process is accompanied by decrease in void ratio which leads to decrease in the coefficient of permeability. The importance of the decrease of the coefficient of permeability on the time rate of settlement and pore water pressure needs to be investigated.
This paper takes into account the change in coefficient of permeability during consolidation and studies its effect on consolidation characteristics of a clay layer. The finite element method is used in the analysis and the packag
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Dyspepsia is a significant public health issue that affects the entire world population. In this work, we formulate and analyze a deterministic model for the population dynamics of Gut bacteria in the presence of antibiotics and Probiotic supplements. All the possible equilibria and their local stability are obtained. The global stability around the positive equilibrium point is established. Numerical simulations back up our analytical findings and show the temporal dynamics of gut microorganisms.
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