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.
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
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The research aimed to evaluate the financial performance of the Public Company for the manufacture of medicines and medical supplies / Samarra - Iraq to know the strengths and weaknesses that affect its performance, as well as to compare its performance in the years between (2017-2019), which are characterized by security stability with its performance in previous years (2014 -2016) which is characterized by security instability, to assess the extent of its ability to achieve growth in performance, by answering the main question, what is the evaluation of the performance of the Public Company for the manufacture of medicines and medical supplies / Samarra - Iraq in the light of financial indicators?
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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 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
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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 MoreLanguage always conveys ideologies that represent an essential aspect of the world we live in. The beliefs and opinions of an individual or community can be organized, interacted with, and negotiated via the use of language. Recent researches have paid attention to bullying as a social issue. They have focused on the psychological aspect of bullying rather than the linguistic one. To bridge this gap, the current study is intended to investigate the ideology of bullying from a critical stylistic perspective. The researchers adopt Jeffries' (2010) critical stylistics model to analyze the data which is five extracts taken from Hunt’s Fish in a Tree (2015). The analysis demonstrates
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Abstract
Indeed, being busy with the understanding of religion is the best sort of worship that the almighty God has given each period of time a number of scholars and wise men. They receive what has been passed down to them from their great ancestors, and those who are willing to learn will learn, their students preserve their knowledge through teaching and writing. Thus, the scholars were pioneers in this field due to the value and importance of their knowledge. They have strived in learning, explaining, and writing new subjects.
One of those scholars is sheikh (Abdulrahman Al-Penjweni) who passed away 1319 AH in one of the villages of the city of Sulaimani in Iraq. He was one of the wisest scholars, a br
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