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.
Basic Orientation and search path in determining the impact of creative thinking in cultural intelligence field research on the doctors competence, as is a theme of creative thinking great importance in spite of being a old , but his role at the individual level and / or organizational a sustainable effect toward developing a fact uncommon , any sense that one of the pillars of modernity and provide a unique future, as is the competitive weapon of the organizations in an environment dubbed fundamental change and provide all that is unfamiliar, and in the center of the field of research and objective measurement of creative thinking on doctors specialists at the construction of a state of the preference and
... Show MoreOur aim was to investigate the inclusion of sexual and reproductive health and rights (SRHR) topics in medical curricula and the perceived need for, feasibility of, and barriers to teaching SRHR. We distributed a survey with questions on SRHR content, and factors regulating SRHR content, to medical universities worldwide using chain referral. Associations between high SRHR content and independent variables were analyzed using unconditional linear regression or χ2 test. Text data were analyzed by thematic analysis. We collected data from 219 respondents, 143 universities and 54 countries. Clinical SRHR topics such as safe pregnancy and childbirth (95.7%) and contraceptive methods
Praise be to Allah, Lord of the Worlds, teach the pen, taught the human what he didn't know, Ihmad - Almighty - and thank him, and repent to him and ask forgiveness, which is the most forgiving, and bear witness that there is no god but Allah alone has no partner, gives and prevents, And I bear witness that Muhammad is a slave to Allah and his Messenger, who called for guidance and good speech and spoke, peace be upon him and his family and companions, and those who followed them until the Day of Judgment.
This study is marked by: The ignorant poem and body language
Its main objective is to reveal the manifestations of this language in the text mentioned, and accordingly, the sieve poem has been read semantic (semantic) and hermeneutic, revealing the poet's ability to employ symbols and signals (body language) in the poem chosen for this purpose; The existence of such language in pre-Islamic poetry. After a long reflection and reading, the signs and symbols of the physical movement of the body, and its feminine and aesthetic manifestations were identified, and this was achieved through the use of modern critical methodologies that directly affect this language. The study consisted of an introduction and three topics, followed by t
After completion of the artistic production, the artist plays the echo of this production upon the recipient. Whether this recipient is from the public, art connoisseurs, or private artists, critics and academics. In the past, the boundaries of Time and place had a great effect in limiting this echo or its quality, as the views of the recipients were largely influenced by the prevailing thought or the artistic trends that dominate the artistic scene in the surrounding environment in which the artist created. In order for the artist to show works for the widest segment of the recipient, he bears the burden of the costs of transporting the work, a keeper of damage on the move, and the material amounts that may hinder the publication of the
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Idiomatic expressions in Russian journalism make one important borrowed means for making a dialogue with the receiver's intellect in so far as it has the distinct feature of having clarity and exactness of meaning. The meaning is seen as a shortcut for covering a series of concepts and details so as to arrive at the intended meaning. This is done by stimulating the reader by the use of certain clear idioms. The use of such idioms in a journalistic text is not for a linguistic purpose only, but it is a cultural and social phenomenon reflecting the type of current changes in the society and it aims at discoursing with the reader's mind. This paper is a practi
... Show MoreI've led an end to the Palestinian presence in the Jordan to the occurrence of a major fault line in relations between Jordan and the Palestinian on the levels of all , and as a result sought King Hussein and the initiative of the U.S. to heal the rift that solution between Jordanians , Palestinians, and the regulation of relations between the two parties announced in March 1972 for the project and unitary featuring Jordan and Palestine in the Arab kingdom united with the two countries , but that the Palestine Liberation Organization and the Palestinian resistance factions rejected by asserting that it is has the right of self-determination of the Palestinian people and no one else , and rejected by the Arab states and ( Israel ) , and l
... Show MoreThe study aims to identify how to build the media message in an artistic design style (infographic) to reach the mechanism of building the media message by infographic in the researched news sites. For the survey method, which is one of the best methods used to study the subject of the research, the researcher used the method of content analysis, the employee of the research tool, a quantitative and qualitative content analysis form for the study of 74 infographics that appeared during the research period in the research sample sites. The study revealed a number of results, most notably 1. The surveyed sites employed the information in a manner based on images, shapes and data, that is, through the use of the visual element and the
... Show MoreMany people, especially among the youth or scholars, wonder about the position of Islam or the scholars of faith on the terminology used by scholars of theology in a certain period of time, and then circulated by people throughout the times and to the present day, such as the terms (the old, the maker, the updated, the cause and the cause) and so on, and this What I felt myself while teaching this subject from some of the students, some of whom consider it blasphemy, and some of them consider it an innovation of speech, and so there were many questions about this subject, which led me to write and research it, after relying on God Almighty, although the research is not long due to the nature of This topic on the one hand, and because I d
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Büyük dil bilgini Kaşgarlı Mahmud’un Divan-ı Lugat-it Türk isimli muazzam eseri, 1910’a kadar adı bilinen, fakat kendisi meçhul bir eserdi. Diğer bir deyişle, o zamana değin, eserin sadece adı vardı, fakat kendisi ortada yoktu. Eser, bugün bütün dünyada biliniyor, hakkında kitap, makale yazılıyor ve üzerinde tartışmalar yapılıyorsa, bunu büyük kitap aşığı, ilim ve kültür sevdalısı Ali Emiri Efendi’ye borçluyuz. Ali Emiri Efendi, Abbasi Halifesine sunulmak üzere Bağdat’ta 1072-1074 yıllarında Kaşgarlı Mahmud tarafından yazılan bu muhteşem eseri, sahaflarda Divan-ı Lugat-it Türk olduğu bilinmeden satılı
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