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.
Brainstorming is one of the fundamental and necessary concepts for practicing the auditing profession, as auditing standards encouraged the implementation of brainstorming sessions to reach reasonable assurance about the validity of the evidence and information obtained by the auditor to detect fraud, as the implementation of brainstorming sessions and the practice of professional suspicion during the audit process lead to increase the quality of auditing and thus raise the financial community's confidence in the auditing profession again after it was exposed to several crises that led to the financial community losing confidence in the auditing profession.
The research aims to explain the effect of brain
... Show MoreThis study aims at recognizing the levels of comprehension of the students of basic schools to the concepts of mathematical geometric and discovering the existing of the differences among students in the level of understanding of the concepts of mathematical geometrical which is due to the change of gender.
The sample of the study is the students of Basic schools, eight level in the basic school of Erbil city, particularly 7-8-and 9 levels in the academic year 2013-2014. The sample consists of 444 students in both genders238 males and 206 females.
The tool of the study is test sheet included 20 items of multiple choice. The items are valid since are given to a jury of expert
... Show MoreThe importance of Public Relations activity has increased during the last half of the last century as a specialized and modern administrative function in most institutions. It has, moreover, become an integral part of activities of those institutions of various types, due to its pivotal role in building its reputation and drawing a good mental image among its audiences, as well as its influential and basic role in maintaining communication and the communication between its members at its various levels and their job tasks to ensure the greatest amount of understanding and to enhance trust between them. This is why public relations activity has become indispensable in all institutions, and without it, it is difficult to achieve any coordi
... Show MoreThe research (Relationship of Communities of practice in adoption of, Strategic Change choices) aims to diagnose and interpretation of correlation nature between Communities of practice deportation (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, projec
... Show MoreThe current research aims to identify the impact of the amputated story style in the collection of sixth graders in elementary in the written expression subject.
The researcher, intentionally, chose Al-Ameen primary hybrid school which belongs to the directorate of education in Baghdad / Karkh first. The number of people of the sixth grade three classes. The researcher chose the two classes randomly to represent one of the experimental group, the number (32) pupils (male and female) have studied the expression subject by the amputated story style. Other control group, the number (32) pupils studied according to the traditional method.
The researcher prepared the lesson plans and presented to the experts, the researc
... Show MoreThe issue of peace, renunciation of violence, and acceptance of the other is one of the vital issues that rose to the top of the list of priorities at the end of the last century and the beginning of the new millennium of the conscience of the Iraqi people by spreading the culture of peace. In this context, we seek during this research to identify the concept of the culture of peace and its impact on sustainable development, and to draw a set of results and suggestions to consolidate this culture in our Iraqi society as an obligation of sustainable development.
A mathematical model has been introduced to investigate the effect of nuclear reaction constant ( A ), probability of the BEC ground state occupation Ω i, nD is the number density of deuteron (d) and the overall number of nuclei ND on the total nuclear d-d fusion rate (R). Under steady-state of the condensates of Bose-Einstein, the postulate of quantum theory and Bose-Einstein theory were applied to evaluate the total nuclear (d-d) fusion rate trapping in Nickel-metal The total nuclear fusion rate trapping predicts a strong relationship between astrophysical S-factor and masses of Nickel. The reaction rate trapping model was tested on three reaction d(d,p)T, d(d, n)3He and d(d, 4He)Q = 23.8MeV respectively. The reaction rate has described
... Show MoreFeatures is the description of the image contents which could be corner, blob or edge. Corners are one of the most important feature to describe image, therefore there are many algorithms to detect corners such as Harris, FAST, SUSAN, etc. Harris is a method for corner detection and it is an efficient and accurate feature detection method. Harris corner detection is rotation invariant but it isn’t scale invariant. This paper presents an efficient harris corner detector invariant to scale, this improvement done by using gaussian function with different scales. The experimental results illustrate that it is very useful to use Gaussian linear equation to deal with harris weakness.
Abstract
The study aims to identify the degree of citizenship values practiced by Bisha University students and identify the impact of gender, college, and academic level, on the degree of the practice of University students for citizenship values. The researcher used the descriptive-analytical method including a questionnaire of (44) items. To process the data, the researcher applied the computational averages, standard deviations, percentages, and T-test. The questionnaire was implemented on a sample of (600) of the 2 and 8 levels during the second semester of the academic year (2020-2019) at Bisha University. The study findings revealed that the degree of the pra
... Show More The current research aims at transforming the concept of implication from the rhetoric into the industrial design in order to have a new term (the design implication) in which the industrial designer takes all or part of another's design to imply his design in it and acknowledge that, and if he did not do so, it would be (design theft) parallel to the literary plagiarism.
In order to show the potentials of the industrial design in the production of new formulations of the industrial products forms, as the design is the carrier of language that addresses the recipients, it is possible to use the implication as a the tool of literature in the design and as a design strategy as it is one of the concepts that takes its course in e