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.
Abstract
The current study aims to identify university students' attitudes towards reading and its relationship to some demographic variables in the universities of the Sultanate of Oman. The study sample consisted of (1434) male and female university students from various Omani public and private universities affiliated with the Ministry of Higher Education. The study covered all (11) governorates of Oman. The researcher adopted the descriptive analytical approach. The researcher employed a scale of reading attitudes to collect the needed data. The study results showed that university students' reading attitudes recorded a high degree. The results also showed there are statistically significant differences at th
... Show MoreThis study measured and analyzed job satisfaction among faculty members at the university of Irbid College in relation to gender social status, years of experience, academic rank , qualification, the population consisted of 110 full-time Jordanian factually members. A total of 72. (61%) factually, members participated in this study. The research instrument which was developed by the researcher consisted of tow parts: personal information and the job Satisfaction Questionnaire Frequencies, percentages, means and one-way analyses of variance were employed to analyze the data. The level of significance was set at 0.05. A Secheffe method of multiple comparisons was used for follow-up investigation.
... Show MoreThe aim of the research is to identify the imaginative thinking skills included in the content of the chemistry textbook for fifth-grade students in biological sciences at the preparatory stage, which is approved by the Ministry of Education, General Directorate of Curricula in the academic year 2020-2021. To achieve the objective of the study, the researcher depends on the previous studies in the field and content of imaginative thinking skills for preparing a list of skills that includes (3) essential skills and (11) sub-skills and (28) items related to all skills. The researcher adopted the analytical descriptive approach because of its appropriation of the goals of the research. Then the researcher analyzed the content of the book de
... Show MoreThe aim of the research is to diagnose the nature of the relationship between the dimensions of organizational immunity with its dimensions represented by (organizational memory, organizational DNA, organizational learning) in enhancing the strategic capabilities of the company with its dimensions represented by (marketing capabilities, administrative capabilities, technological capabilities, creative capabilities), and the degree of arrangement of those dimensions According to priority, as well as revealing the differences in the respondents’ response to the two variables according to the personal and functional variables, and the importance of the expected results, the researchers adopted the questionnaire as a tool for collecting da
... Show MoreThe current study aims to examine the level of problems faced by university students in distance learning, in addition to identify the differences in these problems in terms of the availability of internet services, gender, college, GPA, interactions, academic cohort, and family economic status. The study sample consisted of (3172) students (57.3% females). The researchers developed a questionnaire with (32) items to measure distance learning problems in four areas: Psychological (9 items), academic (10 items), technological (7 items), and study environment (6 items). The responses are scored on a (5) point Likert Scale ranging from 1 (strongly disagree) to 5 (strongly agree). Means, standard deviations, and Multivariate Analysis of Vari
... Show MoreMeasuring the level of communicative competence in news headlines and the level of stylistic and semantic processing in its formulation requires creating a quantitative scale based on the bases on building the scales and their standards. As judging by scientific of journalism studies lies in the possibility of quantifying the journalistic knowledge, i.e. the ability of this knowledge to shift from qualitative language to its equivalent in the language of numbers.
News headlines and editorial processing are one of the journalistic knowledges that should be studied, analyzed stylistically and semantically; their conclusions drawn and expressed in numbers. Press knowledge is divided into two types:<
... Show MoreThe aim of the present work is to develop a new class of natural fillers based polymer composites with sawdust (S.D) which used two particle sizes (1.2 μm & 2.3 μm) and different weight percentage from sawdust (10%, 15%, and 20%). The mechanical properties studied include hardness (shore D) for all samples at normal conditions (N.C). The unsaturated polyester (UPE) and its composites samples were immersed in water for 30 days to find the effect of particle size of sawdust (S.D) on the weight gain (Mt %) by water for all the samples, also to find the effect of water on their hardness. The results show that the composite materials of sawdust (S.D) fillers which has particle size (1.2 μm) better than (2.3 μm) particle size bef
... Show MoreHuman witnessed over the centuries many of the important issues faced by the international community was centered on human rights in general and the persecution of refugees, especially according to many forms may be directly or indirectly leaves behind economic crises, social and humanitarian push world countries to rethink the mechanisms and the feasibility of developing agreements and laws and the role of international and regional organizations to protect peoplerefugeestatus.
Background: spontaneous abortion constitutes one of the most important adverse pregnancy outcomes affecting human reproduction, and its risk factors are not only affected by biological, demographic factors such as age, gravidity, and previous history of miscarriage,but also by individual women’s personal social characteristics, and by the larger social environment. Objective:To identifyEnvironmental effects on Women's with Spontaneous Abortion. Methodology:Non-probability(purposive sample)of(200) women, who were suffering from spontaneous abortion in maternity unitfrom four hospitals at Baghdad City which include Al-ElwiaMaternity Teaching Hospital, and Baghdad Teaching Hospital at Al-Russafa sector. Al–karckhMaternityHospita
... Show MoreNumerous regions in the city of Baghdad experience the congestion and traffic problems. Due to the religious and economic significance, Al-Kadhimiya city (inside the metropolitan range of Baghdad) was chosen as study area. The data gathering stage was separated into two branches: the questionnaire method which is utilized to estimate the traffic volumes for the chosen roads and field data collection method which included video recording and manual counting for the volumes entering the selected signal intersections. The stage of analysis and evaluation for the seventeen urban roads, one highway, and three intersections was performed by HCS-2000 software.The presented work plots a system for assessing the level of service
... Show More