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 surgery Keywords: Non-surgical treatment of anal fissure, fissure in ano, sphicterotomy,botulinum toxin in anal fissures, glyceryl trinitrate. Chemical sphincteratomy, pharmacological sphincteratomy.
Represent choices Behaviorism available to the Managerial leaders one of the prerequisites to run any beginnings of a psychological or dilemmas Managerial barriers to working in the field of work has been varied these options until it had taken several kinds of which contributed to the left different impacts on the alleviation of these problems, which prompted the researcher to raising the problem of study within the framework of questionable content how to contribute to that shown by Choices Behaviorism accredited to the Managerial leaders in the management of frustration
... Show More
A faunistic review of the genus Chaitophorus Koch, 1854, including four species in Iraq is given; the distribution data of each species and their hosts have been recorded. In this investigation the poplar leaf aphid Ch. populialbae (Boyer de Fonscolombe, 1841) is recorded here for the first time in Iraq on popular trees Populus euphratica Oliv. during the period from November 2016 to April 2017 in Baghdad province.
A brief description for apterous viviparous female of this species is given; and a key to the species of the genus Chaitophorus is constricted.
(1)
(1)
This study aims to identify the level of students’ awareness at Imam Muhammad bin Saud University of the requirements of married life in the light of social changes and suggested methods to deepen this awareness (according to the Islamic educational vision) from their own perspective. In this study, the researcher used the descriptive approach with a survey research method, depending on questionnaires to collect data, which he applied to students of College of Sharia in Imam Muhammad bin Saud Islamic University, as well as, students in the fields of Sociology, Social Work, and Psychology in the College of Social Sciences. The findings of the study revealed that students are aware of the requirements of married life concerning mutual ri
... Show MoreEquilrium, kinetic and mechanistic studies for thcoordination of
|
some amino acids "'AA'1
glycine, alanine, .a:ncl histidine, to Cr (Ill)
center of trans .[Cr(ox}2(B.2 0hr {TJ'} cornplein monderarely acidic
range ofpH=4.8-6-.7 ( p =Q.4M NaN03) are reported. The equili rium
c.onsta:nts at 25°C .were found logKequ.=4.95J ,5.206and5.128for glycine, alap.ine, md
... Show MoreThe present study aimed to identify the extent to which the content of social and national studies courses was included in interactive thinking maps in the educational stages in the Kingdom of Saudi Arabia, and to achieve the goal of the study, the researcher used the descriptive and analytical approach, and the study tool used consisted of a content analysis card; Where it included a list of the types of thinking maps, where the study sample consisted of all social and national studies courses at the elementary and intermediate levels, and it is (12) books for the student in its first and second parts, and after verifying the validity and reliability of the tool, it was applied to the study sample, and the study reached conclusions, inc
... Show MoreAsthma is a chronic respiratory disease highly prevalent worldwide. Recent studies have suggested a role for microbiome-associated gut–lung axis in asthma development. In the current study, we investigated if Resveratrol (RES), a plant-based polyphenol, can attenuate ovalbumin (OVA)-induced murine allergic asthma, and if so, the role of microbiome in the gut–lung axis in this process. We found that RES attenuated allergic asthma with significant improvements in pulmonary functions in OVA-exposed mice when tested using plethysmography for frequency (F), mean volume (MV), specific airway resistance (sRaw), and delay time(dT). RES treatment also suppressed inflammatory cytokines in the lungs. RES modulated lung microbiota and cause
... Show More
(51)
(50)
Purpose: We report a series of 29 pediatric patients who sustained head injuries due to metallic ceiling fans. They all were admitted to the Emergency Department of Neurosurgery Teaching Hospital in Baghdad, Iraq, during January 2015 to January 2017. Results: Pediatric ceiling fan head injuries are characterized by four traits which distinguish them from other types of head injuries; 1- Most of them were because of climbing on or jumping from furniture between the ages of two and five. 2- Most of them sustained compound depressed skull fracture which associated with intracranial lesions and pneumocephalus. 3- The most common indication for surgical intervention was because of dirty wound which mixed with hairs. 4- These variables were stati
... Show More
(8)
(8)
The process of coordination and joint cooperation between SAIs and internal auditors in the public sector is considered one of the very important matters in performing efficient audits and are of high quality, especially if this coordination and cooperation is implemented in accordance with international standards, as it leads to avoiding duplication in auditing work. And the distribution of work in a distribution that achieves the objectives of auditing in general and is of general benefit to the economic unit.
The research problem lies in the weakness of the relationship between internal auditing and external auditing as a result of not applying INTOSAI Standard (9150) coordination and joint cooperation
... Show MoreThe study aims to investigate the effect of the Six Thinking Hats Strategy on the achievement of essay writing skills among third-year students in Arabic Language and Literature who are Persian speakers enrolled in the course of Essay Writing (III) at Shiraz University for the academic year 2019-2020. The sample of the study consisted of (15) male and female students who were taught according to the pre-posttest, using the quasi-experimental approach. After applying the statistical analysis on the scores of the post-test, the results showed that there are statistically significant differences in the average of students' achievement in the skills of essay writing in terms of using the Six Thinking Hats Strategy. The results also proved th
... Show More