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 study aimed to build a suggested conception for employing gamification in teaching the general education curricula. Using the analytical method of the previous analytical studies in Teaching, which agreed with the determinants of the analysis of 20 studies from 2014 to 2019, they come on order: points, badges, leaderboards, and then levels. The four most commonly used theories are the theory of self-determination, flow theory, the theory of planned behavior and social theory. In addition, the researcher identified the most commonly used models in gamification, respectively: the ARCS model and the user-based design model. Based on the results of the analysis and using the descriptive approach, the researcher presented a practical perc
... Show MoreIn Production and Operations Management the specialists have tried to develop a strategy to counter the risks arising from the activities of the organization and of waste of various types and therefore the risk management in the contemporary framework represents a phenomenon of new quality, and can not be this phenomenon to take practical dimensions, but the development of culture of the organization towards the risks and deal with all aspects and paint ways to address them within an integrated program, and requires new skills and systems provide accurate information capable of coordination between the various parties within the organization.
The research aims to develop a blu
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The article critically analyzes traditional translation models. The most influential models of translation in the second half of the 20th century have been mentioned, among which the theory of formal and dynamic equivalence, the theory of regular correspondences, informative, situational-denotative, functional-pragmatic theory of communication levels have been considered. The selected models have been analyzed from the point of view of the universality of their use for different types and types of translation, as well as the ability to comprehend the deep links established between the original and the translation.
Аннотация
Age, hypertension, and diabetes can cause significant alterations in arterial structure and function, including changes in lumen diameter (LD), intimal-medial thickness (IMT), flow velocities, and arterial compliance. These are also considered risk markers of atherosclerosis and cerebrovascular disease. A difference between right and left carotid artery blood flow and IMT has been reported by some researchers, and a difference in the incidence of nonlacunar stroke has been reported between the right and left brain hemispheres. The aim of this study was to determine whether there are differences between the right and left common carotid arteries and internal carotid arteries in patient
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The concept of education is not actually restricted to children or school students, but rather every person should be educated and followed up if he is intended to grow and prove, with effort and time allocation as to fulfill that goal. Thus , the current paper aims to a thinking education and to educate that thinking in teacher and it is not new to deal with the personal characteristics of teacher in the different scientific , and educational researches . But ,these research did not address the necessity of acquiring the skill of thinking, especially as it affects teacher's presentation of the content of the curriculum or even content outside the curriculum, and therefore, there is n
... Show MoreA field-pilot scale slow sand filter (SSF) was constructed at Al-Rustamiya Sewage Treatment Plant (STP) in Baghdad city to investigate the removal efficiency in terms of Biochemical Oxygen Demand (BOD5), Chemical oxygen demand (COD), Total Suspended Solids (TSS) and Chloride concentrations for achieving better secondary effluent quality from this treatment plant. The SSF was designed at a 0.2 m/h filtration rate with filter area 1 m2 and total filter depth of 2.3 m. A filter sand media 0.35 mm in size and 1 m depth was supported by 0.2 m layer of gravel of size 5 mm. The secondary effluent from Al-Rustamiya STP was used as the influent to the slow sand filter. The results showed that the removal of BOD5, COD, TSS, and Chloride were
... Show MoreThe anatomic characteristics of the leaves of 22 taxa of Stachys L. representing seven of the currently recognized sections distributed in northern Iraq, were examined. The study did not found any variations in the characteristics of the stomata system of the leaves.Therewere variations with a good taxonomic value in other anatomic characteristics.Thevariations in characters of the mesophyll tissue in S.kurdica var.brevidens Bom ex Bhattacharjeewas bifacial but in S.kurdica var.kurdica Boiss. & Hohen.was unifacial .The study also found that the taxa S.benthamiana Bioss., S.lanigera (Bornm.) Rech.f. andS.kotscyi Bioss. with 3 vascular bundles in the middle vein while the taxa S.ballotiformis Vatke., S.megalodonta Hausskn. &Bornm.exP.H.Davis
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Background: Increasing interest in quality of life (QoL) is the new approach for understanding and improvement of health care. Although there are many studies about quality of life, there is deficiency of data about quality of life of peoples survived from terroristic explosions.Objectives: To study the QoL for peoples survived from terroristic explosions and compare it with that of a controlled people. Methods: This study was conducted between, 1st of July till 31st of December 2013. The sample of this study was collected from peoples attending the outpatient clinics in four primary health care centers, Baghdad city (2 from Rusafa and 2 from Karkh). 183 individuals proved to be exposed to terroristic explosion and 199 individual not exp
... Show MoreThe research aimed to identify the extent to which the media offices in the ministries depend on the website of the Iraqi Council of Ministers as a source of information. Such goal includes a set of sub-goals: Knowing the reasons for media offices' reliance on the information provided by the Cabinet's website; and revealing the benefit derived from relying on the Cabinet's website.
The researcher used the survey method to screen and comprehend the extent to which the media offices in the ministries depend on the website of the Iraqi Council of Ministers as a source of information.
The mechanism of comprehensive account of the limits of research wa
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The human intellect and his ability to complex thinking is a characteristic that Allah has given him above all his creatures. Islam came to encourage the utilization of the mind by thought, contemplation and consideration of the kingdom of Allah, His signs and religion, and He gave us a set of legislation that preserves the mind and protects it from falling into error or deviation.
This research deals with one of the most important components of civilizations in general and Islamic civilization in particular, which is thinking and what is related to it. It is an essential and influential component in man's dealing with life around him and the for
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