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.
Objective: To suggest a weighted measure to diagnose the reasons for the low student success ratios in mathematics concerning the third grade of intermediate schools in light of components educational system represented by: [Students, Teachers, Curriculum, and Environmental reasons (others reasons)] assuming differentiated and interrelated components, Also the effectiveness forming of these components according to the gender variable. Methods: Data collection tools were prepared by constructing two questionnaires for each of (Students and Teachers), which included a number of items that involved some domains for studied components of educational system, which demonstrated a high level of validity and reliability in the pilot study, in addi
... Show MoreThe administrative leadership relies on a variety of behavioral paths in the functional areas in which it operates, and thus indicates its ability and thus has the upper hand in the organizational events, and in such a way that it can draw lessons and evaluate the results so as to test the expectations within the framework of the changes.
Does the study sample leadership have the characteristics that enable it to contain both crises and environmental stresses?
The aim of the study was to determine the location of the administrative leaders in the system of the study sample from the issue of crises and environmental pressures. The study concluded with a number of conclusions, the m
... Show MoreLet R be a commutative ring with non-zero identity element. For two fixed positive integers m and n. A right R-module M is called fully (m,n) -stable relative to ideal A of , if for each n-generated submodule of Mm and R-homomorphism . In this paper we give some characterization theorems and properties of fully (m,n) -stable modules relative to an ideal A of . which generalize the results of fully stable modules relative to an ideal A of R.
In this paper , an efficient new procedure is proposed to modify third –order iterative method obtained by Rostom and Fuad [Saeed. R. K. and Khthr. F.W. New third –order iterative method for solving nonlinear equations. J. Appl. Sci .7(2011): 916-921] , using three steps based on Newton equation , finite difference method and linear interpolation. Analysis of convergence is given to show the efficiency and the performance of the new method for solving nonlinear equations. The efficiency of the new method is demonstrated by numerical examples.
This study aims to reveal the semiotic of “March of Return” cartoon in the Palestinian journalism, topics, Symbols and semantics that were covered.
This study is descriptive. It uses the survey method. Content analysis, and methodological comparison was also used.
The researcher chose an intentional sample of Palestine and Al-Hayat Al-Jadida newspapers for one year from March 30, 2018 to March 31, 2019, through a comprehensive inventory of all cartoons of the return marches during this period, which amounted to 59 cartoons.
The study has reached the following findings:
Newspapers cartoons focused on the topics of durability of the protester
... Show MoreThe Beggar (1965) is a story of isolation and depression which is written by the Egyptian novelist Naguib Mahfouz who is considered the father of Arabic Literature in the modern era. Specifically, he refers in his great novel called The Beggar that the man unable to achieve psychological revival after Nasser’s revolution, the man sacrificed his own job and his family for a desire that increases his feelings of alienation and depression which leads him to an emotional outcry against the indifferent. The main aim of the study highlights the concept of existential dilemma as a philosophical problem and personality crisis by the protagonist of The Beggar novel, Omer Al-Hamzawi who had acc
... Show MoreThe structure of the interrogation process in cross-examinations is said to be diverse and complex in terms of question-response typology. This is because the counsel has to extract truth from an opposing party’s witness whose views are expected to advocate that party's views regarding the case. Accordingly, the study which is basically quantitative in nature aims to investigate what the examining party intends to obtain out of these questions and which of these questions are the most prevalently used. It also aims to measure the amount of cooperativity in witnesses' responses. Accordingly, three transcripts of cross-examination have been analyzed, using a pragmatically-oriented approach. The approach draws on Stenstorm (1984) and Arch
... Show MoreIn the present study, free convection heat and mass transfer of fluid in a square packed bed enclosure is numerically investigated. For the considered geometrical shape, the left vertical wall of enclosure was assumed to be kept at high temperature and concentration while the opposite wall was kept at low temperature and concentration with insulating both the top and bottom walls of enclosure. The Brinkman– Forchheimer extended Darcy model was used to solve the momentum equations, while the energy equations for fluid and solid phases were solved by using the local thermal non-equilibrium (LTNE) model.Computations are performed for a range of the Darcy number from 10-5 to 10-1, the porosity from 0.5 to 0.9, and buoyancy ratio from -15 t
... Show MorePsoriasis is a dermatological, chronic, immune-mediated condition. Psoriasis symptoms are not associated with physical burden only, but it may also have psychosocial effects on patients, diminished cognitive control, poor body image and impairments in everyday life. The value of quality of life is important since improving it is the principal goal for non-curative disease. The aim of the current study was to evaluate quality of life in a sample of Iraqi patients with psoriasis. This study is a cross-sectional study that involved 300 already diagnosed psoriasis patients who attended to the center of Dermatology and Venereology, Medical City/Baghdad. The mean age of patients was (35.156 ±10.549 years). The Arabic version of Dermatology Li
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