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.
This research aims to analyze the indicators of spatial variation in the guide of health field in both Al-Adhamiyah and Rusafa districts according to the environmental and administrative units in 2016. The analysis was done by groups of health guide indicators. The objectives of the study were to identify the spatial variation of health services and assess the health situation for families following the environmental and administrative units of the studied area. Such objectives can be done by specifying the extent of the families’ consent to the type of services, measuring the cases of deprivation, and identifying the most deprived areas. The study has finally concluded that there is a clear spatial variation between the indicators and
... Show MoreThe aim of this paper is to know the persuasive methods and public relations strategies in building the reputation of the United Arab Emirates, since the UAE is progressing among the international indicators in good reputation. The researcher used the survey method, using the content analysis tool, to analyze the publications of the UAE Ministry of Foreign Affairs and International Cooperation for the period from 10/1/2021 to 12/31/2021.The researcher reached a set of results, the most important of which are: The UAE Foreign Ministry relied on public relations strategies in order to build a good reputation for the country, as it focused on the media strategy and gave little importance to the consensus-building strategy, as well as focuse
... Show MoreThe effect of 5555 strategy on reading comprehension among 4th preparatory students Assist. Prof. Dr. Hassan Khilbas Hammadi College of Education Ibn Rushd – The University of Baghdad Assistant Lecturer. Waleed Khaled Talib Directorate – General For Education Province Of AL - Anbar The purpose of study is to identify the effect of 5555 strategy on reading comprehension among 4th preparatory students. To do this, null hypothesis was postulated. The author hypothesize that there is no a statistically significant difference at (0.05) level between experimental group's scores who study reading comprehension subject following the 5555 strategy and control group's scores who study the same subject following the traditional method in readin
... Show MorePraise be to God, who started his book with the praise of himself and prayers and peace be upon those who have no prophet after him and his family and companions and those who followed them with charity until the Day of Judgment.
For it is known to every researcher in jurisprudence and its origins that the semantics in terms of formulas for assignment are divided into an order and a prohibition, and I have seen it necessary to write a small research on the prohibition, and since this topic is complex, and has a great impact on the difference of scholars, I decided to write on one issue of it And it is the absolute prohibition and its effect on the difference of jurists, and what is meant by the absolute p
The modern teaching methods, and their importance in achieving the desired learning goals for the individual and the society, have been addressed, as it is necessary to develop the methods, ways and strategies used in the process of teaching the intermediate stages in the various fields in general and the field of physical education in particular, the importance of research is the effect of using the strategy of similarities in teaching some basic skills of basketball for students of the second intermediate. As for the problem of research, the researcher mentioned the lack of use of teachers’ strategy method similarities in the educational units because of its importance, and after study and analysis the researcher found it necessary to i
... Show MoreThe study aimed to determine the impact of energy for the north and south magnetic poles on the the growth of bacteria isolated from cases of tooth decay, 68 swabs were collected from surfaces of faulty tooth, the detected of Staphylococcus aureus
... Show MoreGod Almighty has imposed on us obligations and set limits on us, and among these obligations is the prayer, which is considered a pillar of Islam. And recently on the statement of its importance, and through extensive explanations, they elaborated on the statement of its pillars, its obligations, its Sunnahs, its rituals, and its bodies, and it is known that the imam in prayer is an important part of the parts of prayer. Whoever assumes this responsibility must be aware of these conditions, the most important of which is jurisprudence in religion, and there has been a disagreement between the jurists, especially the owners of the four schools of thought, about who is qualified to lead the imamate, and this is within many and wide details
... Show MoreRegulations of changes in Sharia policy
Variables include jurisprudential rulings that may be subject to change, alteration and interpretation, depending on the mujtahid’s view of the ruling, or changing it and switching to another view, and the variables are the crucial issues that befell the nation of Islam. It was not neglected by Islamic legislation, but rather the setting of controls that took into account in every incident the norms, interests and purposes.
Objectives: To assess general social factors for elderly in geriatric homes in Jordan.
Methodology: The study was conducted for clients residing in elderly homes. A purposive sample of (155)
residents were selected. Social resource scale by (Duck University Center) called (OARA) older adult resources
and services was used as tool for data collection. The questions extract data about family structure, patterns of
friends and visiting, availability of a confident, satisfaction with the degree of social interaction and availability
of a helper in the event of illness or disability and the program of trips in the houses.
Results: The findings revealed that the life expectancy for women is greater than for men. In respect to
This study aimed to identify the attitudes of school teachers and principals at basic government schools in Ajloun governorate towards the inclusion of disabled students at basic schools, and investigate how they will accept the merger. To achieve the purpose of this study, a questionnaire containing 35 items was administered to school teachers and principals to measure their attitudes toward the inclusion of disabled students in regular schools. The sample of this study consisted of 43 male teachers and (74) female teachers and principals. The frequency, normal distribution, arithmetic means and t-test were used to analyze the data of present study. The findings showed that there
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