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 focus of this research lies in the definition of an important aspect of financial development, which is reflected on the alleviation of poverty in Iraq, namely financial inclusion and then taking the path of achieving a sustainable economy, certainly after reviewing one of the important international experiences in this regard and finally measuring the level of financial inclusion in Iraq and its impact on poverty reduction through the absolute poverty line indicator.
Background: Osteoporosis is one of the major public health problems from which more and more people in the world are suffering. There is evidence suggesting that osteoporosis knowledge is one contributor to osteoporosis preventive behavior. Aim of the Study: To assess the knowledge regarding osteoporosis risk factors, prevention, and management in women of reproductive ages. To identify any association between knowledge and studied factors.
The Turks used the Ottoman Turkish language from the thirteenth century to the twentieth century. During this period and under the influence of Islamic civilization, a large number of words and structures were used from the Arabic and Persian languages, Therefore, many Arabic grammatical structures were used in the Ottoman Turkish language, such as the definite article simply because it was widely used.
The paper is concerned with the use of the Arabic definite article in the Ottoman Turkish language, and the aim of this contrastive study is to find out the similarities and differences between the two languages in terms of meaning and structure. Since linguistic studies depend on the practical side or applied approach, two
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Helminthiasis is a significant economic burden on grazing cattle. Increased resistance to currently available synthetic anthelmintics used to treat helminthiasis, and anthelmintic residues in meat and dairy products pose a significant worldwide health threat. These obstacles require the development of new anthelmintics capable of combating drug resistance while also exhibiting improved safety profiles. Rhynchosia cana (Fabaceae) is a herb that has historically been used as a worm expeller. To evaluate the phytochemical profile and explore the anti-oxidant and anthelmintic effects of different extracts of Rhynchosia cana (R. cana) by In silico and In vitro methods. Using standardised chemical t
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The current research aims to find out ( the effectiveness of the structural model of learning in the acquisition of geographical concepts at the first grade average students ) , and achieving the goals of research has been formulating the null hypothesis of the following :
" There is no difference statistically significant when Mistoi (0.5 ) between the mean scores of the collection of students in the experimental group that is studying the general geographical principles " Bonmozj constructivist learning " and the mean scores of the control group , which is considering the same article ," the traditional way " to acquire concepts.
The researcher adopted th
... Show MoreStudies and scientific research conducted in the field of communication have shown that broadcasting has a clear impact on the ideas, attitudes and behavior of the masses if it is better used in making the media message studied.
The role of this means is not only to present opinions and ideas, but also to influence trends by supporting or changing them. This is of course a matter for the nature of the content in terms of its formulation and the way it is prepared and presented. The power and appeal of a radio message is not complete by simply creating content without creating a distinctive design; and to what extent this content depends on the logic and psychology of persuasion.
The conviction of the cont
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This study aims to recognize the process of using computer in publicschools in Ma`an governorate in terms of hardware, capabilities, and teachers usage. It also aims to identify the most important obstacles those schools face from a teachers perspective.
The study sample consists of (150) teachers from different disciplines. The researcher prepared two questionnaires related to the research pivotal, then presented to a group of arbitrators to be used in this final form. The data was analyzed statistically and the study concluded that there is a shortage in the computer services provided to teachers, and there is a w
... Show Morethis research aims to identify the impact of teaching with ana logies in collection of chemistry students grade average.And direction in order to verify to the zero hypothesis has been formulated and validated,The researcher conducted experiment lasted a full semester as experimental design was chosen (exactly)two equal one pilot and another officer.The research community has been selected one of intentional Middle School of the Education Directorate in B aghdad Karkh second either search sample consisted of (68) students from second grade average (34 ) Students for each group randomly selected research groups was equal to the following variables (lifetime months,parent of first grade chemistry degrees average test informat
... Show MoreThe importance of the interpretation of the Holy Qur’an is that it is a necessity that accompanies Muslim throughout his life, it helps him to solve his problems, it is a way of gaining advanced knowledge, it facilitates the Muslim's understanding of the Holy Qur’an and to know God’s Almighty’s intent in His verses. Since there are so many needs that a person strives to achieve, therefore, the interpretation of the Holy Qur'an would be satisfactory to him and it facilitates the fulfillment of these needs within the limits of legal laws. The aim of the researcher is to get acquainted with the method of that honoured interpreter in his interpretation, and his ability to benefit Muslims in explaining the verses and come to a solutio
... Show MorePraise be to God, Lord of the worlds, and prayers and peace be upon our master Muhammad and upon his family and companions.
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The research dealt with an important and critical era in the history of the Seljuk State of the Romans in Asia Minor, as that country, after the assumption of Sultan Ghiath al-Din Kehsaru II in the year 634 AH / 1236 CE, was subjected to the constant Mongol threat, so the research came marked with (the Seljuk State of Rome in Asia Minor and the Mongol invasion 634 - 708 AH / 1236 - 1308 AD) The research showed the succession of the Seljuk Sultans to the rulers whose rule after the death of Sultan Alaeddin Kikbad was weak and subject to the authority of the Mongols