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.
Research summary
Today, the Islamic nation is going through a phase that is one of the most dangerous that it has never experienced before. This phase was characterized by the following:
The nation is divided into states and its weakness in most of its doctrinal, political, social, economic and moral aspects.
Enemies targeting the nation's faith and capabilities, and the emergence of loyalty to the enemies of the nation from some groups of society, spreading misconceptions in the Muslim community.
Spreading the spirit of rebellion in all segments of society and striving to stir up the people against the rulers and put pressure on the rulers.
All these manifestations and others require the nation's wise men
... Show MoreThe current research aims to know the effect of gardens ideas strategy on deductive thinking among fourth-grade science students in physics.
To investigate from the aim of the research, researchers put the following zero hypothesis:
- No statistically significant differences at the level of significance (0.05) between the students mean scores of the two groups on indicative thinking test.
The research was carried out on the scientific fourth grade male students in Al – Mansour in Baghdad; belong to Education Directorate Al- Karkh /1, for the Academic Year (2014-2015) A.D.
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... Show MoreThe current study aimed to identify key consumer rights and the nature of the work of organizations and traders in the Algerian market through the opinions of the study sample. To prove the hypotheses the researcher depended on the data obtained by the questionnaire prepared for this purpose. She distributed 384 questionnaires out of which only 300 were returned.
The data were analyzed using several statistical techniques such as the Statistical Package for Social Studies system, in addition to percentages, frequencies, and standard deviation.
And a number of conclusions and recommendations were presented. The most important results are:
- There is a strong correlation between safety and compensation rights.
- There is a st
The global globalization the world is experiencing has enabled international actors—states, international governmental and non-governmental organizations, such as liberation movements, international social movements, and even terrorist organizations—to use cyber power to achieve their goals. Therefore, this study discusses the impact of information power on the domestic environment of the United States.
This research aims to analyze the indicators of spatial variation in the guide of health field in both Al-Adhamiyah and Rusafa districts according to the environmental and administrative units in 2016. The analysis was done by groups of health guide indicators. The objectives of the study were to identify the spatial variation of health services and assess the health situation for families following the environmental and administrative units of the studied area. Such objectives can be done by specifying the extent of the families’ consent to the type of services, measuring the cases of deprivation, and identifying the most deprived areas. The study has finally concluded that there is a clear spatial variation between the indicators and
... Show MoreThe aim of this paper is to know the persuasive methods and public relations strategies in building the reputation of the United Arab Emirates, since the UAE is progressing among the international indicators in good reputation. The researcher used the survey method, using the content analysis tool, to analyze the publications of the UAE Ministry of Foreign Affairs and International Cooperation for the period from 10/1/2021 to 12/31/2021.The researcher reached a set of results, the most important of which are: The UAE Foreign Ministry relied on public relations strategies in order to build a good reputation for the country, as it focused on the media strategy and gave little importance to the consensus-building strategy, as well as focuse
... Show MoreThe use of different materials in the art of ceramics is considered a new form of contemporary philosophical trends. That was introduced to art as a result of societal changes and transformations and rapid technological development. And it plays a very essential part in the beauty of the artistic structure. The contrast of using different materials in ceramics is considered a part of the old historical achievements since the art of ceramics used to follow strict standards. Which does not apply to contemporary ceramic, Because recently, it has become free from any religious and social control and created a whole new intellectual context, heading to new horizons in which it works with the newly added materials as a strategy to ensure the a
... Show MoreThe researcher used the experimental approach due to its suitability and the nature of the research problem. The research community was represented by the eighth-grade students in the Rozak Elementary Mixed School affiliated with the General Directorate of Education in Erbil / the center, for the academic year (2021-2022), the number is (96) students, and the research sample consisted of (63) male and female students, with (31) in the experimental group, and (32) in the control group, and (11) students were excluded by (5) students from the experimental group, and (6) students from the control group, as the excluded, are students who failed and were absent from the lessons, and accordingly, the research sample became composed of (52) mal
... Show MoreThis research is represented by exploring the experience of "the theater of the oppressed" by (Augusto Boal) as an experiment that represents a different aesthetic pattern in the presentation of theatrical performance which is in contrast with the Aristotelian and Brechtian patterns, and as a result of the increasing problems of the individual in societies according to his needs and an attempt to express the suffering of human and the loss of his rights in general.
The research also tries to uncover the power of identification and the alienation of existence in the theater of the oppressed as that power, with its diversity of legal, legitimate, religious, political, economic and social capabilities has become a burden instead of being
Objective: In order to evaluate the effect of different typed of Separating Medium on the roughness of the fitted
tissue surface of acrylic denture base.
Methodology: Chosen three types of separating medium (Group A Tin foil), (Group B Detery Isolant),(Group C
Cold Mould Seal),used 30 samples of hot cure acrylic resin ,10 samples for each group, after complete curing of
these samples , Profilometer device was used to measure the surface roughness of each sample in all groups.
Results: Using One Way ANOVA Test and LSD test, the results were highly significant in differences among all
groups. Although (Group A) showing lest roughness, (Group B) showing a satisfactory result of roughness, While
(Group C) Showing the hig