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 selective information broadcasting service is one of the important services in libraries and information centers, as it is the link between the source and the beneficiary and between related sources, as it links similar sources through keywords and then sends them to beneficiaries, which contributes to reducing the time and effort spent by beneficiaries in obtaining sources or information. Therefore, the application of this service is an important matter and gives a positive indicator in the progress of the library towards the integration of its services. From this standpoint, this research came to answer some questions, including: 1. What are the outlets for beneficiaries (the research community) in obtaining information sources? 2. Wh
... Show More The current research aims at transforming the concept of implication from the rhetoric into the industrial design in order to have a new term (the design implication) in which the industrial designer takes all or part of another's design to imply his design in it and acknowledge that, and if he did not do so, it would be (design theft) parallel to the literary plagiarism.
In order to show the potentials of the industrial design in the production of new formulations of the industrial products forms, as the design is the carrier of language that addresses the recipients, it is possible to use the implication as a the tool of literature in the design and as a design strategy as it is one of the concepts that takes its course in e
It’s an attempt to identify the cultural activities of the Ministry of Culture, Tourism and Antiquities, which are provided by the Ministry of Culture, Tourism and Antiquities and the departments affiliated with the Ministry of Culture only, not tourism and antiquities. The most important results areIs that the Ministry of Culture, Tourism and Antiquities has many cultural activities such as (festivals, exhibitions, conferences, fashion shows, concerts, musical evenings, theatrical and cinematic performances) in addition to literary series and cultural magazines, which are directed to the public in general, whether it is elite or not, and this shows the extent The importance of cultural activities published by the Ministry of Culture, Tou
... Show MoreThis study aims at recognizing the levels of comprehension of the students of basic schools to the concepts of mathematical geometric and discovering the existing of the differences among students in the level of understanding of the concepts of mathematical geometrical which is due to the change of gender.
The sample of the study is the students of Basic schools, eight level in the basic school of Erbil city, particularly 7-8-and 9 levels in the academic year 2013-2014. The sample consists of 444 students in both genders238 males and 206 females.
The tool of the study is test sheet included 20 items of multiple choice. The items are valid since are given to a jury of expert
... Show MoreThe issue of peace, renunciation of violence, and acceptance of the other is one of the vital issues that rose to the top of the list of priorities at the end of the last century and the beginning of the new millennium of the conscience of the Iraqi people by spreading the culture of peace. In this context, we seek during this research to identify the concept of the culture of peace and its impact on sustainable development, and to draw a set of results and suggestions to consolidate this culture in our Iraqi society as an obligation of sustainable development.
The research aimed to identify the effectiveness of instructional design according to whole brain theory of Herman in the achievement of chemistry at the fifth scientific students at a secondary school of the General Directorate for Educational in Diyala / Baladruz in Iraq. The research sample Consisted of (57 student, (29) students as experimental group studied according to instructional design strategies for whole brain theory of Herrmann and (28) a student as a control group studied by the usual way for two semesters, a prepared achievement test as article and objective type of multiple choice, the coefficient stability of alpha-Cronbach equation reached (0.86). The research Results showed the presence of a statistically significant d
... Show MoreThe current research aims to identify the impact of the amputated story style in the collection of sixth graders in elementary in the written expression subject.
The researcher, intentionally, chose Al-Ameen primary hybrid school which belongs to the directorate of education in Baghdad / Karkh first. The number of people of the sixth grade three classes. The researcher chose the two classes randomly to represent one of the experimental group, the number (32) pupils (male and female) have studied the expression subject by the amputated story style. Other control group, the number (32) pupils studied according to the traditional method.
The researcher prepared the lesson plans and presented to the experts, the researc
... Show MoreThe study aimed at ideutifying the impact of scieutific skills in strategy and liabits of mind amony stueuts in tenth grade . The study demanded to choose a sampie that coutaiun (42) student of the fourth grade of the secondary school who were dirided into tow groups , the first is experimental studied according to scieutific skill strategy , and the other controlling , studied according to the usualway . An achievement test has been taken that adopted staudard for mind skills as research tools that are applid after ascertaining sincerity proved at the end of the experiment .The study has reached to the conclusion that there are statistically significant differnces in farour of the experiment group in both
... Show MoreThis paper addresses the new coloring in the concept of dystopian society as represented by the positive role of one of the characters vs. the passive role of the government and its mutual effect on the people of the society. In addition, it describes how all men in the dystopian society victimize and degrade the other through unlawful acts, like: stealing, rape, and fear, which are the lowest points in a moral decay. However, it offers hope by illustrating a positive sense, as exemplified by the doctor's wife out of Saramago's optimistic view that men may be descended from good women. Accordingly, the paper aims to examine the effect of the government’s role in the lives of the people who have later turned into blind in a dystopian so
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To achieve the goals, the researcher followed the design of equal and independent groups of partial control and post-test . The research has chosen the Institute of Fine Arts in the area Almansour area as deliberate sample where three sections of students have been chosen and the number of students is (69) students. The researcher conducted equivalence in the variables (age, and IQ , and the overall rate for grade III). in diagnostic phase, (21) concepts of alternative image out of (46) concepts have been identified in addition to the goals of formulation of acquisition concepts according to the three processes (definition, discrimination and application). Achievement test has been
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