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.
Iraq within the ranks of the fledgling communities characterized by a broad base of the population pyramid, because they pose the age group (under 15 years) of a large proportion of the community, as it exceeded the proportion (40%) during the years of research extended (1986-2010) Despite the relative decline in the rates fertility during that period, but the proportion of young people remained high, especially for groups of at least five years, amounting to about 14% in 2012, a little more than the proportion of what constitutes age group (5-9 above) years, where it was (13%) and this naturally predicts continuing population increases in coming decades, due to the entry of those numbers of individuals in the reproductive stage,
... Show MoreThe researcher used the experimental approach due to its suitability and the nature of the research problem. The research community was represented by the eighth-grade students in the Rozak Elementary Mixed School affiliated with the General Directorate of Education in Erbil / the center, for the academic year (2021-2022), the number is (96) students, and the research sample consisted of (63) male and female students, with (31) in the experimental group, and (32) in the control group, and (11) students were excluded by (5) students from the experimental group, and (6) students from the control group, as the excluded, are students who failed and were absent from the lessons, and accordingly, the research sample became composed of (52) mal
... Show MoreThis research is represented by exploring the experience of "the theater of the oppressed" by (Augusto Boal) as an experiment that represents a different aesthetic pattern in the presentation of theatrical performance which is in contrast with the Aristotelian and Brechtian patterns, and as a result of the increasing problems of the individual in societies according to his needs and an attempt to express the suffering of human and the loss of his rights in general.
The research also tries to uncover the power of identification and the alienation of existence in the theater of the oppressed as that power, with its diversity of legal, legitimate, religious, political, economic and social capabilities has become a burden instead of being
In general, the importance of cluster analysis is that one can evaluate elements by clustering multiple homogeneous data; the main objective of this analysis is to collect the elements of a single, homogeneous group into different divisions, depending on many variables. This method of analysis is used to reduce data, generate hypotheses and test them, as well as predict and match models. The research aims to evaluate the fuzzy cluster analysis, which is a special case of cluster analysis, as well as to compare the two methods—classical and fuzzy cluster analysis. The research topic has been allocated to the government and private hospitals. The sampling for this research was comprised of 288 patients being treated in 10 hospitals. As t
... Show MoreBackground: Although bleaching is typically considered a safe procedure, various investigations have found minor negative effects and changes in mineral composition. The aim was to Evaluate and compare the efficacy of using Nanohydroxyapatite serum on surface microhardness of enamel surface before and after bleaching with chemically cured Boost bleaching. Material and methods: ten sound human permanent upper and lower premolar teeth were used and their roots were removed 2 mm apically to the cementoenamel junction, the crowns were sectioned mesiodistally into two halves buccal and lingual/palatal, the buccal surface was further subdivided into two halves. The samples were embeded in an acrylic resin, resulting in 30 specimens divide
... Show MoreThis study aimed to develop scale of Selectiv Mutism with pupils of primary schools according to their teachers' view in Baghdad city (Karh and Resaf(.
Children might choose the mutism as the solution to avoid some psychological and social problems that surrounded them. Furthermore, this could consider as a disorder that could effect the child and led him to use the Selected Mutism.
This is supported by the pilot study which was conducted by the researcher on 150 teachers in different primary schools in Baghdad. The results revealed some symptoms were found with children who have selected mutism.
Because of there was no scale was found to measure the Selected Mutism, a scale was develop in order to measure t
... Show MoreIt aim current researchs֬ to identify the impact of a proposed strategy in accordance with the objectives of science in the achievement and some science processes, where the experimental method was adopted, and define the research community was students second grade averag in Education Bagdad / Rusafa third, research sample intentionally chosen as school Radwan, and (30) students experimental group and (29) of control group, research tools were achievement test and the test of science operations and use the appropriate statistical tools to process information and data, showing results, the experimental group surpassed the control group in the collection and operations science, and light it, the researcher recommended several recommendat
... Show MoreTechnology developed at very rapid paces in the last decade of the twentieth century and what followed, especially communication technology, as the World Wide Web appeared in the mid-nineties of the last century, Facebook in 2004 and 2006, the mobile phone, 1993, 1994, and social networking sites. The other. These technological developments have had an impact on societies, whether among individuals in one country or among different peoples. The citizen in any part of the world has become a journalist who practices the work of a specialized or professional journalist, even if he does not know how to read and write, or has a low level of education, as he can now transmit events from wherever he is to the world, through his personal page, or v
... Show MorePraise be to God, Lord of the Worlds, who has made His way for His servants who know in the depths and who are devoted to Him at all times and times, so He has delivered to Himself their pain from two exiles, and His prayers and peace are the perfect trust in the presence of the pearl of charity of existence. Possessor of great intercession and praiseworthy status until the day of meeting and eternity, and upon his family and companions, the people of tomorrow, steadfastness, generosity, and generosity, and after that
For a long period of time, I have been asking myself: Why did he attack so many contemporary books, especially Sufism? Why this unlimited financial expenditure on printing, binding, beautifying and enticing readers?
... Show MoreIn this work Polyynes was synthesized by pulse laser ablation of graphite target in ethanol solution. UV-Visible Spectrophotometer, Fourier Transform Infrared Spectroscopy (FTIR) and Transmission electron microscopy (TEM) were used to study the optical absorption, chemical bonding, particle size and the morphology. UV absorption peaks coincide with the electronic transitions corresponding to linear hydrogen – capped polyyne (Cn+1H2), the absorption peaks intensity increased when the polyynes were produced at different laser energies and the formation rats of polyynes increased with the increasing of laser pulse number. The FTIR absorption peak at 2368.4 cm-1, 1640.0 cm-1 and 1276.
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