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 City of Ember is a very interesting novel that is although intended for young readers, have so many layers and messages that are misunderstood. In this research, both the novel and the film adaptation are studied with the intent to decode the warning messages that the novelist and the director tried to introduce to the audience. The research studies four vital messages; the first message is that history repeats itself for the novel has many allusions to the history of Jews and their painful holocaust and even goes back in history the days of Moses and the Exodus, the second message tackles the conspiracy theory that states nothing happens by accident and that everything is planned and connected hence comes the third message
... Show MoreThe duration of the contract is a legal term first provided for in French Amendment Decree No. 131/2016, and given the increasing importance of time in contracts, we have chosen to study the legal rules governing time at the formative stage by drawing on changes in French law compared to both Iraqi and Egyptian laws. Article 1102 of French Amendment Decree No. 131/2016 stipulates that: "Everyone is free to contract or not to contract, to choose the person with whom he contracts, and to determine the content and form of the contract within the limits established by law." Contractual freedom does not permit a breach of the rules relating to public order), as well as article 1104, which provides for (contracts must be nego
... Show MoreThe banking sector of all kinds is the backbone of the economy in all countries, as it is the main financier of most economic projects in order to achieve economic development and achieve stability, which contributes to providing the necessary resources in return for obtaining a profit margin in exchange for giving up his money and bearing credit risks. Among the aforementioned banking sectors are: Islamic banks that invest their capital in several forms in order to obtain profits that enable them to continue and grow, and the most important of these formulas is the Murabaha formula, which is summarized by the bank selling a commodity after owning it and then selling it to the applicant for this commodity based on a prior request
... Show MoreMembrane manufacturing system was operated using dry/wet phase inversion process. A sample of hollow fiber membrane was prepared using (17% wt PVC) polyvinyl chloride as membrane material and N, N Dimethylacetamide (DMAC) as solvent in the first run and the second run was made using (DMAC/Acetone) of ratio 3.4 w/w. Scanning electron microscope (SEM) was used to predict the structure and dimensions of hollow fiber membranes prepared. The ultrafiltration experiments were performed using soluble polymeric solute poly ethylene glycol (PEG) of molecular weight (20000 Dalton) 800 ppm solution 25 °C temperature and 1 bar pressure. The experimental results show that pure water permeation increased from 25.7 to 32.2 (L/m2.h.bar) by adding aceton
... Show MoreThe flexibility of interaction between the movement of macroeconomic variables that affect and are affected by the balance of payments, especially the movement of the current account, implies a perception of the maturity of economic development and what the theory assumes from the launch of a wide range of economic movement that varies in the degree of its influence according to the level of economic development and the vitality of the internal/external overlap relations through the assumed response to the movement of the macroeconomic variables. On this basis, it is possible to estimate the soundness and rationality of the economic decision taken that takes into account the required reciprocal repercussions between the current a
... Show MoreThe research tagged (the image of the soldier in contemporary Iraqi painting) dealt with the concept of the image as one of the basic concepts in the creative achievement, whether it is in the field of art, literature or beauty. Therefore, the concept of the image expanded to express the various aspects of human creativity, including the field of painting. To know the image of the soldier in contemporary Iraqi painting, the research included four chapters. The first chapter focused on the methodological framework of the research, while the second chapter included three sections. The first topic dealt with the philosophical and artistic concept of the image. The second topic was concerned with the representations of the soldier's image in
... Show MoreThe research aims to measure the accounting conservatism practice of listed companies in the Iraq stock exchange using Basu model to measure the degree of accounting conservatism in a sample of companies of (21) companies for the period from 2007 to 2011, the researcher found that most of the listed companies in the market exercised accounting conservatism when measurement and disclosure of the result of the activity and financial position and there is a variation in the degree of accounting conservatism between economic sectors , which included banking , investment , insurance , industry , agriculture , tourism and hotels.
Because the practice of accounting conservatism properly
... Show MoreThis research aims to identify the effectiveness of counseling by using the technique of self-talkin developing the habits of mind among middle school students by testing important hypotheses, and choosing the experimental design for the two groups (experimental - control). The classification of "Costa & Kallick" was adopted to measure the habits of the mind, and the scale consisted of (64) items, and after confirming the psychometric properties of the scale, the researcher applied it to the research sample (487) students from middle school students. One of the students who got the lowest marks after answering the scale. purpose of applying the experiment. He divided them into two groups, one of them is experimental (10) students, as
... Show Morethis research seeks to shed light on the study of the impact of Putinism on the Russian-Ukrainian war that broke out in early 2022, by studying the contents of the speeches of Russian President Vladimir Putin before the start of the war. This research uses the structural approach in analyzing the components of the Russian political regime. The research tools used in this research include case studies, content analysis of Russian speeches, and personal meetings of researchers and specialists in Russian affairs. It sums up a number of important conclusions, most notably are : 1) Putinism is a totalitarian regime that includes the political doctrine during the era of Russian President Vladimir Putin. 2) Duginism represents the totality of t
... Show MoreIn The Name of Allah Most Gracious Most Merciful
The characteristics of the doers of good are mentioned in the Holy Book of God, and love for them in five places, and whoever God loves, honors him and gives him victory. As for the love of the righteous, it has to do with loyalty, covenant, and integrity. Committing sins 0 Then after that he mentioned God those who fight in His cause and those who rely on Him and return to Him and turning away from everything else.