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 tagged (the image of the soldier in contemporary Iraqi painting) dealt with the concept of the image as one of the basic concepts in the creative achievement, whether it is in the field of art, literature or beauty. Therefore, the concept of the image expanded to express the various aspects of human creativity, including the field of painting. To know the image of the soldier in contemporary Iraqi painting, the research included four chapters. The first chapter focused on the methodological framework of the research, while the second chapter included three sections. The first topic dealt with the philosophical and artistic concept of the image. The second topic was concerned with the representations of the soldier's image in
... Show More
The development of human resources training programs has an applied and important role in the preparation of human cadresin terms of capacity to absorb technical sciences and skills and scientific and practical practices at faster rates in order to bealighed with continous development. Hence the recognition of the significant role that human resources play in the economy of any country,which has stressed the interest towards the economic unity of the qualified staff that it needsin atimely manner through the ongoing training process in the era of high technology day by day In this regard ,the current research deal with accounting of human resources and its impact on reducing costs in the military establishment and the
... Show More
The most important topics that constitute the aesthetic and substantive aspect of the theatrical performance represented by the spatial environment of the presentation and the proposed virtual place that contains the technical and artistic elements of the presentation and highlights the strength of influence on it. In light of the above, the researchers divided the topic into four chapters.
The first chapter contained (the methodological framework), which included the research problem with regard to the directing treatments between the directors in establishing or creating theatrical venue, the importance of the research and the aim of the research, and the limits of the research to conclude the chapter by defining the terms.
... Show More
New membrane electrodes for determination of ciprofloxacin hydrochloride were prepared depending on ciprofloxacin hydrochloride - phosphotungstic acid (CFH-PT) as an active material and these electrodes were made with three plasticizers: Di-octylphenylphosphonate(DOPH), Di-butyl phosphate (DBP)Tri-n-butyl phosphate(TBP), in PVC matrix. One of the ciprofloxacin electrodes was gave Nernstian slope equal to 57.21 mV/ decade for DOPH membrane with concentration range from 1.5×10-5 to1.0×10-1 M, and detection limit equal to 1.5×10-6 M .Lifetime was 93 days. Non- Nernstian responses equal to 39.40 and 30.70 mV/ decade for membranes DBP, TBP, respectively. These electrodes were gave concentration range from 1.0× 10-5 to 1.0×10-2 and from 4.0
... Show More
(9)
This study aimed to identify the role of digital transformation in improving the quality of the internal audit process. The researchers used the descriptive analytical approach, and the questionnaire was relied on as a study tool that was applied to the study population consisting of internal auditors working in banks listed on the Palestine Stock Exchange, and their number was (85). A checker and a comprehensive inventory method was used due to the small size of the community, where the response data of the questionnaire was analyzed and interpreted using the Statistical Packages Program (SPSS).
The results of the study showed that the use of digital transformation contributes to ensuring the quality of
... Show MoreKnowing the nature of the relationship in federal systems lies in studying the political, social, economic and cultural forces, for their role in laying the foundations and the federal system. No matter how important the pillars of that system are, and through this research, we will learn how the political elites were able to crystallize this unique system, until it became one of the political systems that some countries seek to copy and apply its experience.
The research aims to determine the effectiveness of auditing in light of the relationship between the governance of investment policy and the cost of debt in companies listed on the Iraqi Stock Exchange. The problem of the research is to raise the question about the effect of the governance of investment policy and the cost of debt on the effectiveness of auditing and auditors. During the research, the most important of them were: the existence of an impact relationship on the effectiveness of auditing through the relationship between the governance of investment policy and the cost of debt. The companies listed in the Iraqi Stock Exchange lack an effective proposed guide or framework dealing with the governance of investment policy desp
... Show MoreThe current research focuses on a major problem: the weak role of disclosing corporate information in the application of laws, regulations and instructions related to the application of corporate governance principles weakens the ability to protect the rights of shareholders and investors in companies listed on the Iraqi Stock Exchange and the study aims to study and analyze the role of disclosure and transparency in achieving the necessary protection to ensure the rights of shareholders. The study was applied to a sample of (42) analysis samples representing (84%) of the total questionnaires distributed to investors and shareholders in all listed companies in the Iraqi Stock Exchange. The results confirm the shareholder's right to obtai
... Show MoreThe anatomical features of leaves and stems of seven species belonging to five genera of the Papaveraceae family were studied, including: Fumaria bracteosa Pomel, 1875; Glaucium grandiflorum Boissier & A. Huet,1856; Hypecoum pendulum Linnaeus, 1753; Papaver fugax Poiret,1804; Papaver macrostomum Boissier & A. Huet, 1867; Papaver rhoeas Linnaeus, 1753 and Roemeria refracta de Candolle,1821. The results showed that the anticlinal cell walls of the adaxial surface were more thickened in P. fugax, H. pendulum, P. macrostomum and R.refracta, while it was thin in P. rhoeas. The cur
... Show More
(5)
(2)