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 sought to identify the attitudes of PhD students towards establishing the field of educational administration. The study followed the descriptive survey method. The questionnaire was used to collect information from the study community consisting of (95) male and female students in the department of educational administration and Planning. Among the most important results about students ’attitudes towards establishing the educational administration field are the following: 1) identifying the necessity of establishing the educational administration field. 2) Encouraging students to attend seminars and scientific conferences in Islamic rooting. 3) there are no statistically significant differences in the attitudes of doctoral s
... Show MoreThis research aims at clarifying the concept of social auditing, which is one of the most important reasons for its emergence is social responsibility accounting and its role in measuring the social performance of enterprises. The study also aimed to know how social auditing has an impact and its role in improving the social performance of business organizations, and the research refers to testing the hypotheses of an impact of social auditing on social performance through a commitment to social responsibility. The research sample consisted of 200 individuals from 20 Algerian business organizations and represented individuals who were researched in managers and em
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Autorías: Muwafaq Obayes Khudhair, Sanaa Rabeea Abed, Hayder Talib Jasim. Localización: Revista iberoamericana de psicología del ejercicio y el deporte. Nº. 1, 2023. Artículo de Revista en Dialnet.
The body has the ability to effect the audience in the the theatrical show , since he or she is transmitter , sender , seen and viewer of the humanitarian discourse as well the the images and connotations of the theatrical show, it is a tool of communication that substitutes for millions of spoken words, the modern schools of direction focused on the body language of the actor and gave it prominence in depicting facts by different connotations. The researcher studies the physical performance of the actor throughout focusing on the connotational dimensions of the body within the theatrical show , as well as the positioning of performative body within the modern schools of direction depending on the theatrical show (Rebuke ) of the Iraqi d
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This research was conducted to measure the safety of heat stable enterotoxin a (STa) produced by enterotoxigenic Escherichia coli, through studying its toxic effect on human blood lymphocyte, since it showed a promising effect in reducing the proliferation of colorectal cancer cells. the cytogenetic effects of (STa) by using five different concentrations (100, 200, 400, 800 and 1600μg/ml) in comparison with negative (PBS, Phosphate buffer saline) and positive (MMC, Mitomycin C) at concentration of 5μg/ml, controls on human blood lymphocytes obtained from both (10) normal healthy persons and (20) colorectal cancer patients was measured by employing the following parameters: mitotic index, blast index, chromosomal aberrations and micronucle
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