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.
Find cares studying ways in the development of industrial products and designs: the way the progressive development (how typical) and root development (jump design), was the aim of the research: to determine the effectiveness of the pattern and the jump in the development of designs and industrial products. After a process of analysis of a sample of research and two models of contemporary household electrical appliances, it was reached a set of findings and conclusions including:1-leaping designs changed a lot of entrenched perceptions of the user on how the product works and its use and the size and shape of the product, revealing him about the possibilities of sophisticated relationships with the product, while keeping the typical desi
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This study discusses the Critical Discourse Analysis of 2012 American Presidential Election Debate’. The researcher adopts a model proposed by Van Dijk’s (2006 d). Six ideological categories have been selected within the overall strategies of the ideological square are used. The categories are of three levels of discourse structure : (the meaning, the argumentation, and the rhetoric) .They have shown effective criteria for detecting the most disguised systems of racism and manipulation.
Based on the analysis, it can be concluded that the elite discourses of candidates contribute to the reproduction of domination, Orientalism, and Islamophobia. This can be appl
... Show MoreBackground: The use of minerals in treatment of different diseases is as old as man himself. zinc is the most famous trace mineral related to male sexual function. Oligoasthenozoospermic subfertile patients were treated with zinc sulphate for three months.
Objectives: Aim of the research is to investigate the role of Zinc and if it affects the abnormalities of some semen parameters and to study the possible role of pharmaceutical preperations of zinc in amelioration of male subfertility as well as to assess the ability of Zinc to induce changes in the serum and semen zinc levels in addition to the levels of reproductive hormones (FSH and Testosterone).
Type of the study:
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Aims: The present study aims at assessing mothers’ knowledge of breastfeeding in Kirkuk governorate,
besides determining the relationship between mothers’ knowledge and some of their demographic
attributes.
Methodolgy: A descriptive study was used the assessment approach and applied on mothers in Kirkuk
governorate from January 15th 2011 to July 25th
, 2011. Non-probability sampling a convenience sample of
(72) mothers, attending pediatric general hospital in Kirkuk governorate for following up the health status
of their children, was selected for the purpose of the study. A questionnaire was developed for the
purpose of the study. It was comprised of two parts; the first part includes the mothers' demographic
In their growth stages, cities become an aggregation of different urban contexts as a result of development or investment projects with other goals, which creates urban tension at several levels. Previous studies presented different approaches and methods to address specific aspects of urban stress, and thus contemporary visions and propositions varied, which required a field for research. The research, from a review of the proposals, the research problem emerged in need to study the indicators and trends of balanced urban development that address the tensions between different social, economic and urban contexts". Accordingly, the objective of the research is determined as "Building a comprehe
... Show MoreThe textbook is the primary means of creativity and thinking, which has a major role in the development of the readership and mental abilities of the student. It is the basic tool in education in Iraq for the teacher and the student, which cannot be dispensed in any educational program. The current study aimed at the book of the biology of the sixth grade of science in Iraq (comparative study). It was compared to the book of biology for the twelve grade in the Kingdom of Jordan to identify the ratio of similarity and differences between them, in addition, to identify the weaknesses in the Iraq curriculum and developing appropriate solutions and suggestions to address them. The sample was represented with books of biology (six-science cla
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The research aims to build a training program to develop some executive functions for kindergarten children. To achieve this goal, the two researchers built the program according to the following steps:
1. Determining the general objective of the program.
2. Determining the behavioral objectives of the program.
3. Determining the included content in the program.
4. Implementing the content of the activities of the program.
5. Evaluating the Program.
The program included (12) training activities, the training activities included several items: the title of the activity, the time of implementation of the activity, the general objective of the activity, the procedural behavioral objective, the means and tools u
Traditionally, path selection within routing is formulated as a shortest path optimization problem. The objective function for optimization could be any one variety of parameters such as number of hops, delay, cost...etc. The problem of least cost delay constraint routing is studied in this paper since delay constraint is very common requirement of many multimedia applications and cost minimization captures the need to
distribute the network. So an iterative algorithm is proposed in this paper to solve this problem. It is appeared from the results of applying this algorithm that it gave the optimal path (optimal solution) from among multiple feasible paths (feasible solutions).
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A set of ten drug compounds containing an amino group in the structure were determined theoretically. The parameters were entered into a model to forecast the optimal values of practical (log P) medicinal molecules. The drugs were evaluated theoretically using different types of calculations which are AM1, PM3, and Hartree Fock at the basis set (HF/STO-3G). The Physico-chemical data like (entropy, total energy, Gibbs Free Energy,…etc were computed and played an important role in the predictions of the practical lipophilicity values. Besides, Eigenvalues named HOMO and LUMO were determined. Linearity was shown when correlated between the experimental data with the evaluated physical properties. The statistical analysis was used to analy
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