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.
Tax governance is a set of legal means that directs the tax administration to deal in good faith with taxpayers based on transparency, integrity and accountability while ensuring the achievement of tax justice and works to introduce advanced means by which it deals with all stakeholders.
In this study, we try to explain its rooting and legal nature by shedding light on the position of some international organizations and their internal legislation in the context of public finance.
this study deals with effect of diabetes and hypertension on quality of life
The advancement of science and technology in recent years has led to heavy and diversified production and thus market congestion in various goods and services; which led to an increase of competition among advertisers in order to meet the needs and wishes and to upgrade to the level of consumers. These upgrades have imposed an increase in the usage of the promotions, including advertising in terms of quantity and quality, to influence and persuade customers innovatively and creatively using all available mass media.
The research aims to identify the attitudes of residents of poor areas towards television advertisements for medicines, and the impact of those advertisements on them in terms of making purch
... Show MoreThis study aims to identify the role of satellite channels in imparting behavior to children from the point of view of their parents in Tulkarm city. The researcher used a descriptive technique. A sample of (18000) males and females married couples was used above 20 years old in the city of Tulkarm. The study sample size is (201) married couples. It took place in September 2020. The questionnaire was the main tool for collecting data. The study found that the total degree of satellite channels contribution in imparting negative behaviors to children was high, as it reached (72.20%). The total degree of the role of satellite channels in imparting positive behaviors to children was medium, reaching (69.20%). Moreover, the results also indi
... Show MoreThis study aimed to identify the role of digital transformation in improving the quality of the internal audit process. The researchers used the descriptive analytical approach, and the questionnaire was relied on as a study tool that was applied to the study population consisting of internal auditors working in banks listed on the Palestine Stock Exchange, and their number was (85). A checker and a comprehensive inventory method was used due to the small size of the community, where the response data of the questionnaire was analyzed and interpreted using the Statistical Packages Program (SPSS).
The results of the study showed that the use of digital transformation contributes to ensuring the quality of
... Show MoreAgricultural lands have great importance in people's lives, and their exploitation has a great impact on strengthening the national economy. Therefore, countries have given great importance to this sector, and because of the importance of this sector, the state has given large areas of these lands to the farmers to invest in agriculture, and among these farmers are those who died and left behind children who took up crafts. Agriculture, for fear that these agricultural lands would be abandoned and turned into waste lands, a land system was introduced called (regular distribu- tion), which corresponds to (legitimate inheritance). Under this system, these lands were trans- ferred to the children of farmers who died so that the process of inve
... Show MoreImproving the quality of health services in the health sector is an important and necessary matter that must be taken care of and improved, and this study seeks to demonstrate the role of quality costs in improving the quality of health services and achieving a high level of quality to satisfy the beneficiaries and to provide health services of good quality, and the research concluded that the main point of service provision Good health is the costs of prevention and evaluation (costs of quality conformity) and attention to it, and that technical competition contributes greatly to the development of the level of quality, as well as the use of health and medical staff with competent expertise, and that the costs of internal failure and th
... Show MoreIn this study the thermal conductivity of the epoxy composites were characterized as function of volume fraction, particle size of fillers and the time of immersion(30,60,90)days in water .Composites plates were prepared by incorporating (bi-directional) (0º-90º) glass fiber and silicon carbide (SiC) particles of (0.1,0.5,1)mm as particle size at (10%,20%,30%,40%) percent volume in epoxy matrix.
The composites shows slightly increase of the thermal conductivity with increasing volume fraction, particle size and increase with increasing the days of immersion in water. The maximum thermal conductivity (0.51W/m.K) was obtained before the immersion in water at 90 days for epoxy reinforcement by bi-directional glass fiber and SiC particl
This study examined the problem of identifying the vocabulary of the methodology of teaching Arabic language in the faculties of Media. The researcher noticed the existence of an overlap between the syllabuses of the general specialization of the Arabic language and its Media sections in the universities with the special professional vocabulary that suits the study of the media student. Thus ,this study is regarded as a real attempt to present a methodological model of media language that concerns with fillfuling students ‘linguistic and knowledgeable needs relying on measuring their benefits from the methodological Arabic curriculum . Key words:problem, teaching’ methodology of Arabic language, media language.
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The development of human resources training programs has an applied and important role in the preparation of human cadresin terms of capacity to absorb technical sciences and skills and scientific and practical practices at faster rates in order to bealighed with continous development. Hence the recognition of the significant role that human resources play in the economy of any country,which has stressed the interest towards the economic unity of the qualified staff that it needsin atimely manner through the ongoing training process in the era of high technology day by day In this regard ,the current research deal with accounting of human resources and its impact on reducing costs in the military establishment and the
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