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 highlights one of the most important issues that have been controversial between Islamic schools, which is the duality of Intellect and Revelation and the nature of their relationship, in two core points:
The first point: Could there be a real conflict between Intellect and revelation? While the school of hadith view that this assumption is a rational assumption that does not real as long as the revelation is correct and the Intellect is clear, and that what is claimed are due to other Intellect s, we find that the Ash’ari school adopts the saying that the real conflict may occur, but rather confirms its occurrence.
The second point: For whom is the priority, for the Intellect or th
... Show MoreA developed model has been put for the hypothesis of capturing moons in explaining the origin of Jupiter moons, and study the change of the orbital properties of these satellites as well as the distance from the planet. Jupiter moons were divided into two types according to their physical and orbital properties, they are the moons , which are formed from the same material as the planet, so it was named the original moons ,while the moons that have been captured from the surrounding space was renamed exotic moons . And the moons of exotic origin asteroid belt and the Kuiper belt in the region which is behind Neptune, the origin of each clique of moons is an asteroid fragmented after colliding previously with another body and
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This research aims to find out "the effectiveness of the self-questioning strategy in the achievement of students Phase III institutes of teacher preparation and decision-making in chemistry." The researcher follows approach quasi-experimental with a post-test, and the sample consisted of (27) from " Teachers Training Institute-AL-Byaa "in Directorate of Education Baghdad Karkh / 2 students divided into two unequal groups: experimental its number (14) students studied using reciprocal teaching strategy and control its number (13) students have studied in the usual way.The two groups were equivalent extraneous variables.
The researcher was prepare achievement test consist of 40 items was the adoption of a measure of decision-makin
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In this paper, the construction of Hermite wavelets functions and their operational matrix of integration is presented. The Hermite wavelets method is applied to solve nth order Volterra integro diferential equations (VIDE) by expanding the unknown functions, as series in terms of Hermite wavelets with unknown coefficients. Finally, two examples are given
The research problem focused through the researcher's experience in the gymnastics game and the lack of use of educational models that give the student an important role in the educational process, so it became necessary to identify the type of prevailing style for students, and the need for diversity in the use of educational models based on scientific theories, including the Daniel Document model. Based on three theories of learning, which are structural, behavioral, and meaningful learning. The research aimed to identify the effect of using the Daniel model for people with two types of brain control (left and right) to learn the skill of the Cartwheel in artistic gymnastics for students of the second stage. The researcher used the experi
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The aim of the research is to develop specific skills of 21 century, one schedule, renewable: (sex, years of experience, academic degree) from the viewpoint of the research sample. The descriptive tool was used to collect information for research purposes. It was applied to a sample of (339) male and female teachers in Al-Ardhah governorate schools to teach Jazan. The application was carried out in the second semester of the year 1442 AH. The research concluded with a set of results, the most important of which are: the approval of the sample members to a large extent on the expressions of the role of school leaders in the practice of developing male and female teachers in acquiring these three skills fr
... Show MoreTranslation is a vital process that needs much more understanding and mutual background knowledge on the part of ESL or EFL learners in terms of grammar , meaning and context of both the SL and TL . Thus , the main aim of the current research paper is to identify and figure out the techniques used by ESL or EFL learners when translating English barnyard verbs into Arabic . The main problem of this study is attributed to the fact that ESL or EFL learners may not be able to identify and understand the connotative meaning of barnyard verbs since these verbs are onomatopoeic (i.e,) a word that phonetically imitates, or suggests the source of sound that it describes. Therefore they may be unable to translate these verbs appropriately and accura
... Show MoreBackground: Tumor associated tissue eosinophilia (TATE) has been described in a variety of neoplasms. In regard to squamous cell carcinoma, some studies worldwide done to assess stromal eosinophilia in oral and cervical squamous cell carcinoma. The objectives of this study is to evaluate the association of stromal eosinophilic infiltration of cutaneous squamous cell carcinoma and to detect the significance of this association. Aim of the study The aim of our study is to establish the relationship between the degree of stromal eosinophilia and the level of invasion and the histological grade in cutaneous squamous cell carcinoma. Methods: In this retrospective study done at the histopathology department of al Wasity teaching hospital for orth
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The research aims to clarify the role that psychological ownership, through its dimensions, plays in deterring the effects of toxic leadership, through its dimensions, in the Ministry of Industry and Minerals. The research started with a basic problem represented by the following question: "Using psychological ownership and its application in deterring the negative effects of toxic leadership." The research used the descriptive-analytical method. The sample was randomly selected from workers in some selected companies affiliated with the Ministry of Industry and Minerals in Baghdad, and the sample size reached 124 individuals. One of the most important results is that there is an effect of the psychological ownership variable, based on the
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