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 persons who Allah Ioves them in the holly Quran
Objectivity Study0Dr 0muyad Turky Ali
Allah men tioned in Auran the loving of benevolent and who Allah loves him gave him everything 0the loving of benevolent came fist and after that the loving of justice who remove injustice and after that loving purified and in noeent 0After that mentioning loving of Knighters ( fighters )The eharity with money and to clear up the justice and loving purified is a reason of accessing paradise 0
The study aims at finding out the effect of the lead time strategy on the first intermediate class pupils' achievement in geography The partial experimental design of two groups, experimental and control, with pre-post tests is used. The sample is represented in (73) female pupils. The sample is divided into two groups (37) experimental group and (36) control one. The sam ple is selected from first intermediate class pupils ( Al Batol intermediate school for girls) Baghdad Al-karkh-3, for academic year 2015-2016 The researcher has equalized the two groups in several variables: the previous achievement tests, intelligence, age in months, the scores of geography test of first course
In this paper the oscillation criterion was investigated for all solutions of the third-order half linear neutral differential equations. Some necessary and sufficient conditions are established for every solution of (a(t)[(x(t)±p(t)x(?(t) ) )^'' ]^? )^'+q(t) x^? (?(t) )=0, t?t_0, to be oscillatory. Examples are given to illustrate our main results.
Experiment Factorial conducted with two factor in field texture silt clay loam soil, the first factor were Two Rotavator plow which different in number of rotary blades on flanges, weight, width, made and type, the second factor were four speeds tractor 2.62, 5.10, 7.55, 9.23 km/hr to compare performance two Rotavator under depth 12 cm and knowledge slippage, distance between beat blades, practical productivity, disturbed soil volume, percentage of the soil clods which have diameter less than 5 cm under complete block design with three replications using Least Significant Design 0.05. Results showed Galucho Rotavator recorder the higher practical productivity 0>7089 ha/hr, disturbed soil volume 809.8 m3/hr, percentage of the soil clods 96.1
... Show MoreMost countries in the world particularly developing countries, including Iraq, facing extremely dangerous problem with social and political dimensions, which is the emergence of the food crisis problem ,the decrease in domestic food production in Iraq isn't meet the needs of its population food, due to the fact that the agricultural sector suffers from multiple natural ,economic and human problems .It is still below the level required to meet the needs of the population of food ,since food at the forefront of priorities needed by the human . This represents indispensable basic necessity , so the responsibility of its availability permanently in appropriate&nb
... Show MoreThis study dealt with the basics of financial inclusion in terms of concept, importance and objectives, The empowerment of women financially and bank ,and then the relationship between financial inclusion and women, and determine the requirements of inclusion Financial resources for women. The analytical descriptive method was used for data, which included reviewing and analyzing information and data in economic and financial literature. The study: reached a number of conclusions, the most important of which are Financial inclusion contributes to women's financial and banking support, as there is a positive relationship between financial institutions Banking and women's access to financial and banking services, thus playing a rol
... Show MoreSince the advent of the sunrise of the immortal message, Islamic legislation has always established justice and the right guidance, and has prevented any perversion, injustice or corruption, with a divine system that called in its course the characteristics of the legislation on its general basis and its ability to develop, progressivity, and paving the way with a collective approach, accompanied by the worldly and moral punishment. When the corrupters went too far, reformers were delayed and values were missed; Mankind has been afflicted with the scourge of injustice and loss, and has lost sight of the approach that the Creator of the world has given to the people of the world, for what would guide them in their affairs sooner and later
... Show MoreThe regression analysis process is used to study and predicate the surface response by using the design of experiment (DOE) as well as roughness calculation through developing a mathematical model. In this study; response surface methodology and the particular solution technique are used. Design of experiment used a series of the structured statistical analytic approach to investigate the relationship between some parameters and their responses. Surface roughness is one of the important parameters which play an important role. Also, its found that the cutting speed can result in small effects on surface roughness. This work is focusing on all considerations to make interaction between the parameters (position of influenc
... Show MoreAbstract\
Dealing economic units at the present time with an industrial environment characterized by competitiveness and the pace of change and its strength as a result of this changing environment shall be on those who made it to adopt strategies that allow them to confront these variables and work in order to meet the market requirements of quality and price appropriate products to suit and the demand for those products and conditions to maintain
its competitive position and its development.
As a result, it became the subject of competitiveness in recent years and enjoys widespread attention at the global level. And in order to keep up
... Show MoreThe study aimed to explore the school principals’ servant leadership practices for primary teachers’ perspectives in the Sultanate of Oman, furthermore to investigate the differences in those practices attributable to variables (gender, qualification, educational stage, years of experience, governorate). The study relied on the descriptive approach, by employing the survey research design using the questionnaire as a main tool for data collection, which included five dimensions of servant leadership (altruism, humility, enhancing teacher development, emotional healing, commitment to community development), Data collected from (1094) teachers in basic education schools, and they were chosen randomly. The results of the study indicated
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