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 researchers pointed that the poet relied on several means in the form of poetic images, including analogy, and the metaphor with its various elements, The chromatic component has also been used in the formation of its poetic image,and resorted to the correspondence of the senses and the symbol of two types:Self-code, public code : And we find a variety of symbolic stems from different sources, from these symbols, what is religious, including what is historical and what is legendary, and such symbols, which resorted to the rare places of his poems confined to the myths contained in the Bible, His use of the general symbols was ineffective in the poetic picture, relying on the metaphor and metaphor.
The adopted method in the teaching of history is conservation and indoctrination in all grades, and this will lead to a lack of students interact with teachers in the course of the lesson, and poor use of teachers to questions that raise students' thinking during the lesson, which leads to a lack of interest in the topic of the lesson and wasting opportunities contribution making it the teacher at the center of the educational process, and to provide arrogating the researcher to contribute to teaching style with the belief that the use of this method of teaching could lead to overcome the difficulties and problems faced by the teaching material.
And there are educational complexes integrated approac
... Show MoreThe study seeks to investigate the effect of Dunn Dunn learning style model on students’ achievement. Besides, the way of developing students’ deductive thinking by testing the null hypothesis: there is no significant difference between experimental group who takes Dunn Dunn model as style in studying geography and control group that follows a traditional method in studying geography at the level of (0,05). Additionally, there is no significant difference between experimental group who takes Dunn Dunn model as style in studying geography and control group that follows a traditional method in studying geography at the level of (0,05) on testing developing deductive thinking skills. The researcher adopted a quasi-experimental posttest
... Show MoreThe present study aims at finding out the (effect of the Caroll’s pattern on the second intermediate class pupils' achievement in geography)
The partial experimental design of two groups, experimental and control, with pre-post tests is used. The sample is represented in (74) female pupils. The sample is divided into two groups (38) experimental group and (36) control one. The sample is selected from first intermediate class pupils ( Am Salama Secondary School for girls) \ Baghdad\ Al-karkh-1, for academic year 2015-2016.
The researcher has equalized the two groups in several variables: the previous achievement tests, intelligence, age in months, the scor
... Show MoreDeveloped technologies and complementary means for viewing theater through the ages, and they affected would improve and get better. Valsinogravea appeared to express a description and identification of existing in the theatrical space of lighting and decorative structure architecture, and the lighting of the elements that have contributed since ancient times in the process of the show, and played a significant role in strengthening the relationship between the recipient and actor and presentation theater as a whole scenes, working to broadcast a dramatic speech theatrical holds ideas and content and symbols and semantics affect the spectator of different age, particularly the child viewer, that little spectator who represent the
... Show MoreCentric study on the interest of the Directorate General of Training and Development / Ministry of Electricity to consolidate the concept of process and enhancement of knowledge in the areas of organizational change، it reached a sample of the study (44) people who are highly heads of departments، technicians and administrators in different sections of the Directorate and by using the correlation coefficient (Spearman) & coefficient of simple regression been tested correlations between variables and the impact of the study، as has been reached to integrate the role of cognitive processes with the areas of organizational change and relationships that were significant at the level of overall dimensions and subsidiary organs.
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After the persistence of the British policy of oppression and control over the American colonies and the attempts to obliterate the identity of their inhabitants, the colonies worked on moving forward towards achieving independence, and Virginia was the first to initiate the development of the new government frameworks, through George Mason in drafting the Virginia Bill of Rights in 1776, which expressed the philosophy of the era Enlightenment and independent revolutionary thought, which called for equality and natural rights for individuals and the need for a free popular government that works for the common good.
(Social values) are of great importance in the lives of nations and peoples as they are the frame of reference that governs the relations of members of society to each other and regulates their life affairs.
And the Prophet of Islam (may God’s prayers and peace be upon him) has told about a group of (social values) such as: spreading peace, feeding food, being fair in dealing with others, and clarifying what a Muslim should have towards his Muslim brother from the safety of the chest and refraining from harming him with the tongue and hand, and so on. Ethics and behaviors that are directly and closely related to (social values).
The best book that abounds with these (social valu
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