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.
In this research we present An idea of setting up same split plots experiments in many locations and many periods by Latin Square Design. This cases represents a modest contribution in area of design and analysis of experiments. we had written (theoretically) the general plans, the mathematical models for these experiments, and finding the derivations of EMS for each component (source) of sources of variation of the analysis of variance tables which uses for the statistical analysis for these expirements
The new 4-[(7-chloro-2,1,3-benzoxadiazole)azo]-4,5-diphenyl imidazole (L) have been synthesized and characterized by micro elemental and thermal analyses as well as 1H.NMR, FT-IR, and UV-Vis spectroscopic techniques. (L) acts as a ligand coordinating with some metal ionsV(IV), Fe(III), Co(II), Ni(II), Cu(II), and Zn(II). Structures of the new compounds were characterized by elemental and thermal analyses as well as FT-IR and UV-Vis Spectra. The magnetic properties and electrical conductivities of metal complexes were also determined. Study of the nature of the complexes formed in ethanol following the mole ratio method.. The work also include a theoretical treatment of the formed complexes in the gas phase, this was done using the (hyperch
... Show MoreThe study aims at figuring out the intended meaning of intonation in some English conversational utterances together with identifying pitch variations that are determined by various syntactic constructions that impart the same illocutionary force of utterances. However, intonation is needed to delimit the communicative forces of utterances by virtue of its structure which the speakers intend to convey .This paper consists of four sections .Section one deals with phonology and its types .Section two discusses intonation in relation to style , forms and functions. Section three sheds some light on pragmatics. Section four deals in details with the intended meaning of intonation in some English conversational utterances. This paper comes up wi
... Show MoreAmong many problems that reduced the performance of the network, especially Wide Area Network, congestion is one of these, which is caused when traffic request reaches or exceeds the available capacity of a route, resulting in blocking and less throughput per unit time. Congestion management attributes try to manage such cases. The work presented in this paper deals with an important issue that is the Quality of Service (QoS) techniques. QoS is the combination effect on service level, which locates the user's degree of contentment of the service. In this paper, packet schedulers (FIFO, WFQ, CQ and PQ) were implemented and evaluated under different applications with different priorities. The results show that WFQ scheduler gives acceptable r
... Show MoreThis study aims to know the extent of the impact of Strategic Leadership as an independent variable in Strategic Learning as a dependent variable to help the senior leadership in Anbar University to take the right decisions to develop Strategic Learning programs in light of the circumstances of the Covid-19 and the sudden decisions adopted by the university to switch to E-learning and to blend. The survey was conducted by distributing a questionnaire that was adopted as a primary tool in data collection from the study sample represented by the university's senior leaders, An intentional random sample of (105) was selected from our community of (127), the data were analyzed by (SPSS) Depe
... Show MoreThe study included the extraction of volatile oil from Mentha piperita which was 1.3 % in the leaves and flowers . Volatile oil of the Mentha piperita leaves had special aromatic odour, pale yellow color, slightly pungent taste . The specific gravity and refractive index were (0.9794) and ( 1.464) respectively. The inhibition activity of the Mentha piperita Volatile oil extracts were studied on some pathogenic microorganisms like Staphylococcus aureus, Salmonella typhi, Escherichia coli, Proteus sp, and Klebsiella pneumoniae . The result showed that the volatile oil had an inhibition effect on the growth of all microorganisms, and it gave the higher inhibition effect on the growth of S. aureus in which the inhibition zone reached to 2
... Show MoreAbstract
The current study aims to identify university students' attitudes towards reading and its relationship to some demographic variables in the universities of the Sultanate of Oman. The study sample consisted of (1434) male and female university students from various Omani public and private universities affiliated with the Ministry of Higher Education. The study covered all (11) governorates of Oman. The researcher adopted the descriptive analytical approach. The researcher employed a scale of reading attitudes to collect the needed data. The study results showed that university students' reading attitudes recorded a high degree. The results also showed there are statistically significant differences at th
... Show MoreThe study of vegetative change of cities is one of the most important studies related to human life because of its direct correlation with the temporal conditions that occur. These include the economic problems that force people to move and look for job opportunities in the city, which leads to an increase in the population density of cities, especially for cities with an important economic and administrative location as in the capital city of Baghdad. In this study, the effect of the increasing in population density was analyzed on the urban planning of Baghdad city. The decreasing in vegetation was due to the increasing of urban areas on the outskirts of the city, which led to an increase in its area. Moreover, urban cities increased t
... Show MoreObjective: to evaluate the results of (Modification of Russe method) in treatment of nonunion fracture scaphoid bone by bone graft with external splintage (plaster of paris cast (pop ). Methods:Prospective study done on 26 patients (24 male, 2 female), age range between 25-42 years (mean age 34 years), fracture site at middle 1/3 with minimal displacements with no carpal bone or radial bone injury, technique of Matte- Russe method (explore the bone through volar approach using bone graft from iliac crest (cortico-cancellous peg plus cancellus bone) with thumb spica for 90 days with period of follow up 12-18 months. Results: out of 26 patients treated by this method , 23 patients (88.5%) union was achieved radiologically by the end of 3rd mo
... Show MoreTo investigate the research objectives, the researchers put the following hypothesis:
There was no statistically significant difference at the level of (0.05) between the average score of the students of the experimental group who studied the language of rhetoric according to model of learning method, and the average score of the students of the control group who studied the same article in the traditional way acquiring rhetorical concept. The researchers relied on the experimental design with the partial setting of the post-test, which depends on the experimental group that is taught using the model of the learning method, and the control group taught using the traditional method.
... Show More