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.
Background: percutaneous balloon dilation of corotation of aorta is a less invasive and alternative to surgical repair for patients with discrete coaction of aorta and although the used of balloon angioplasty in patients with recurrent postoperative coarctation gained a wide consensus, the use this technique for native coarctation is still controversial in children less one years.
Objective: to evaluate the immediate and late result of balloon dilation of native coarctation of aorta in infant and children.
Type of the study: A prospective study.
Subjects & Methods: The study was done on forty-five patients who were referred for cardiac catheterization and balloon
... Show MoreThe reason for studying (The secret of Repentance and Confession in Christianity) goes back to the deep roots of repentance in all religions, specially the three revealed religions, and those who adhere to them. The human psych by nature is incessantly demanding sins and the wrong deeds. It is in need of repentance which God has opened for them. Almighty God is happy when his creatures repent and refrain from sinning. This is the reason for success in life and the hereafter and the principle of the happiness. It is also a condition for the good course. Therefore, man should refrain from sinning and feel regret for committing sins forever.
Praise be to God, who made the pegs of the earth and entrusted them with the task of keeping the earth from tilting, and prayers and peace be upon the one to whom the Qur’an was revealed, Muhammad, and upon his family and all his companions.
The topic of mountains is one of the important topics in human life, as God has associated great miracles with them that indicate the perfection of the power of God Almighty. God Almighty says: (And to the mountains, my palms have turned. This is worthy of every rational person to contemplate His signs, the Almighty, in this solid part and safety belt of the earth, in order to reveal the secrets of the mountains and uncover their treasures. The more the researcher studies the mountains and
... Show MoreObjectives: To determine the (QoL) for patients with permanent pacemaker and to find-out the relationship between
these patients’ (QoL) and their sociodemographic characteristics such as age, gender, level of education, and
occupation.
Methodology: ٨ purposive non-probability” sample of (62) patient with permanent pacemaker was involved in this
study. The developed questionnaire consists of (4) parts which include !.demographic data form, 2.disease-related
information form, 3.socioeconomic data form, and 4.Permanent pacemaker patient’s quality of life questionnaire data
form. The validity and reliability of the questionnaire were determined through the application of a pilot study. ٨
descriptive statistical a
The researcher dealt with the importance of striking proverbs in the Holy Qur’an and their uses and benefits in Islamic education and ethics and between the types of proverbs, so it emerged through the study the following things that the proverbs are of three types: authorized, latent, and transmitted, and it has been shown through the current study that the proverb has conditions that the proverb is not valid except There are five: (realism, clarity, environmental, meaning injury, and good pronunciation). If the example violates these conditions, it is not an example. This study showed that proverbs have a prominent role in persuasion, argument, statement, education, clarity, approximation, education, refinement, correct belief, etc.
... Show MoreObjectives: To assess the quality of life for adult patients with peptic ulcers in the city of Sulaimani.
Methodology: A descriptive study, using the assessment approach was conducted on patients with peptic ulcer
disease from January 12th, 2009 to September 30th, 2009. A purposive "non-probability" sample of (100) paƟents
(males and females) with peptic ulcers who attended Kurdistan Center for Gastroenterology and Hepatology were
selected for the study. A questionnaire was adapted from the World Health Organization quality of life questionnaire
(1998) for the purpose of the study. It is comprised of (3) parts that included sociodemographic characteristics form,
medical history form and adult peptic ulcers patients' qu
The first chapter the importance of research and need for education scientists see that the roots of the use of a specimen Wheatley in learning and teaching back to Grayson Wheatley, one of the largest supporters of a modern construction, which lay the groundwork for the specimen stage and the form in which it is. That was attributed to him, often called his name called while some educators based learning strategy on the issue. He sees the learner in this model make him a meaningful understanding of problems during his progress, thereby acting with his colleagues to find solutions to them in small groups. He
Borders Search: Search by students is determined by th
... Show MoreThis research deals with the aesthetics of describing nature and the joys of urban life in the environment of Fatimid Egypt, among a group of poets, who were deceived by its enchanting beauty and breathtaking scenery, through it they depicted the reality of the life they live, and the things that involved them, as well as showing their personal culture, and the joys of life that experience, articulating this with a descriptive and analytical study, focusing on how the poet portrayed the visual scene, in an important stage of Arabic literature in Egypt.
The aim of this paper is to prove some results for equivalence of moduli of smoothnes in approximation theory , we used a"non uniform" modulus of smoothness and the weighted Ditzian –Totik moduli of smoothness in by spline functions ,several results are obtained .For example , it shown that ,for any the inequality , is satisfied ,finally, similar result for chebyshev partition and weighted Ditzian –Totik moduli of smoothness are also obtained.