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 importance of this research has been to rationalize the cost of producing maize seeds through the followers of modern techniques and methods in agricultural activities such as genetic engineering for the purpose of increasing production efficiency of maize seeds as well as the importance of calculating seed cost rationalization through the ABC system and thus rationalizing government spending. The research is based on a single hypothesis that the use of genetic engineering on corn seeds works to:increase production efficiency of seeds and savings in agricultural inputs, calculation of rationalization through the cost system on the basis of activity ABC The research reached a number of conclus
... Show MoreThis paper addresses the new coloring in the concept of dystopian society as represented by the positive role of one of the characters vs. the passive role of the government and its mutual effect on the people of the society. In addition, it describes how all men in the dystopian society victimize and degrade the other through unlawful acts, like: stealing, rape, and fear, which are the lowest points in a moral decay. However, it offers hope by illustrating a positive sense, as exemplified by the doctor's wife out of Saramago's optimistic view that men may be descended from good women. Accordingly, the paper aims to examine the effect of the government’s role in the lives of the people who have later turned into blind in a dystopi
... Show MoreThe study focuses on Kamez model and the Claus Meyer model of instructional design, which are models that provide the learner with educational experiences to suit the logical information of the learner and the variety of instructional models. Research Objective: The present research aims to identify Limitations of the study. The current research is determined by ((fourth grade preparatory students, the book of the date of the fourth preparatory course)) Chapter II includes Arabic and foreign studies on the model of Kemp and Claus Mayer in the acquisition of concepts and direction towards the material. Chapter III Experimental Design: The researcher adopted an experimental design with two experimental groups and a control group. The resea
... Show MoreThe distribution of the intensity of the comet Ison C/2013 is studied by taking its histogram. This distribution reveals four distinct regions that related to the background, tail, coma and nucleus. One dimensional temperature distribution fitting is achieved by using two mathematical equations that related to the coordinate of the center of the comet. The quiver plot of the gradient of the comet shows very clearly that arrows headed towards the maximum intensity of the comet.
The ulma is one of the most spread social phenomenon.It occupies people in their different tendencies,the ulma imposes itself strongly in their social ,economic and politic sidies.
The problem of freedom quarrel is the older problem in creation .The groups as well as the individuals look for their liberty and it is restricted, they isolate themselves from others for a achieving it. Isolation phenomenon is one of common humanity phenomenon among individuals for looking of individuals psychological and social compatibility with other and society so they feel anxiety and tension and restriction of will and freedom. IT is known that college student from the major never in development and ren
... Show MoreThe current study aimed to determine the relation between the lead levels in the blood traffic men and the nature of their traffic work in Baghdad governorate. Blood samples were collected from 10 traffic men and the age about from 20-39 year from Directorate of Traffic Al Rusafa/ Baghdad and 10 samples another control from traffic men too with age 30-49 year and they livedrelatively in the clear cities or contained of Very few traffic areas. The levels of lead in blood estimated by used Atomic Absorption Spectrometry.
The result stated that there is no rising of the levels of lead in blood of traffic men Lead concentration was with more a range from 14 ppm in Traffic police are not healthy They are within the permissible limits, Ap
The study aimed at ideutifying the impact of scieutific skills in strategy and liabits of mind amony stueuts in tenth grade . The study demanded to choose a sampie that coutaiun (42) student of the fourth grade of the secondary school who were dirided into tow groups , the first is experimental studied according to scieutific skill strategy , and the other controlling , studied according to the usualway . An achievement test has been taken that adopted staudard for mind skills as research tools that are applid after ascertaining sincerity proved at the end of the experiment .The study has reached to the conclusion that there are statistically significant differnces in farour of the experiment group in both
... Show MoreIt’s an attempt to identify the cultural activities of the Ministry of Culture, Tourism and Antiquities, which are provided by the Ministry of Culture, Tourism and Antiquities and the departments affiliated with the Ministry of Culture only, not tourism and antiquities. The most important results areIs that the Ministry of Culture, Tourism and Antiquities has many cultural activities such as (festivals, exhibitions, conferences, fashion shows, concerts, musical evenings, theatrical and cinematic performances) in addition to literary series and cultural magazines, which are directed to the public in general, whether it is elite or not, and this shows the extent The importance of cultural activities published by the Ministry of Culture, Tou
... Show MoreThe research aimed to diagnose and interpretation of impact nature between Communities of practice dimensions (participation and spreading knowledge, confidence, social capital build) deportation strategic change choices (reengineering business process, business re-structuring, business innovation) in construction companies in the Iraqi Ministry of Construction and Housing, the research tested 4 construction companies working in investing sector in Iraq, the research applied on a sample of 102 persons who participated in Communities of practice distributed in several administrative levels (directors, division directors, project directors and engineers) the research used questionnaire as a main tool for dat
... Show MoreThe research aims to find out the impact of Lee’s cognitive strategy on the achievement of fifth-grade literary students in the module of history. The research community consists of the secondary female day schools of Al-Karkh Al-Oula Directorate General of Education. The size of the research sample comprises (45) female students of the fifth grade of the literary brunch, (21) students for the experimental group and (24) students for the control group. The researchers have chosen an experimental design with partial control to suit the current research and its goal. They used a unified tool to measure the achievement of female students, which consisted of (50) items characterized by sincerity and they extracted the stability of t
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