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 settlement rate and pore water pressure dissipation rate are mainly controlled by the permeability of soil. Both laboratory and field tests show that the permeability is varied during the loading and consolidation process. It is known that consolidation process is accompanied by decrease in void ratio which leads to decrease in the coefficient of permeability. The importance of the decrease of the coefficient of permeability on the time rate of settlement and pore water pressure needs to be investigated.
This paper takes into account the change in coefficient of permeability during consolidation and studies its effect on consolidation characteristics of a clay layer. The finite element method is used in the analysis and the packag
Abstract
This research’s goal is to restore and to revive the jurisprudence of Mother of Believers (Um alMuaamineen) “Um Salmah” "may God bless her", and to highlight her outstanding assimilation and understanding of religion and her conscious thought. The current research is a comparative scientific theoretical study represented in the comparison of jurisprudence of “Um Salamah” with Hadiths of fasting and pilgrimage rules as well as the duration mentioned in jurisprudence of for doctrines( 4 schools of thought )to identify these hadiths with the inclusion and discussion of their evidence.
The current research included two topics: the first one is to identify and introduce
... Show MoreThe banking sector of all kinds is the backbone of the economy in all countries, as it is the main financier of most economic projects in order to achieve economic development and achieve stability, which contributes to providing the necessary resources in return for obtaining a profit margin in exchange for giving up his money and bearing credit risks. Among the aforementioned banking sectors are: Islamic banks that invest their capital in several forms in order to obtain profits that enable them to continue and grow, and the most important of these formulas is the Murabaha formula, which is summarized by the bank selling a commodity after owning it and then selling it to the applicant for this commodity based on a prior request
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Abstract
Personality is one of the most important elements that should be developed in university student. Thus, we have to develop the positive traits and neutralize the negative traits of students as well as we have to pay attention to the level of student achievement at the same time, the researcher designed a scale to measure the traits of study sample. The research come out with a number of recommendations and proposals, the most important of which Enhancing the positive characteristics of university students in order to reach them to the level of mature personality with mental health. Enhancing the positive role of the high level of achievement by motivating the stude
... Show MoreThe new events in every era are endless, and it is not required of the legal texts to pursue each event by itself and attach to it its ruling.
At the same time, every event or action must have a Shari’a ruling according to the wise Lawgiver, and our scholars have noted this in every event presented to them. ...etc.
It is well known that reaching the legal ruling on a matter, by examining the detailed evidence, is subject to following the path of the rules and regulations specific to the overall evidence, which we organize on the basis of the principles of jurisprudence.
Therefore, any disagreement about the manner or content of these rules will have an impact on the difference of jurists in partial issues, when examining the d
The anatomical features of leaves and stems of seven species belonging to five genera of the Papaveraceae family were studied, including: Fumaria bracteosa Pomel, 1875; Glaucium grandiflorum Boissier & A. Huet,1856; Hypecoum pendulum Linnaeus, 1753; Papaver fugax Poiret,1804; Papaver macrostomum Boissier & A. Huet, 1867; Papaver rhoeas Linnaeus, 1753 and Roemeria refracta de Candolle,1821. The results showed that the anticlinal cell walls of the adaxial surface were more thickened in P. fugax, H. pendulum, P. macrostomum and R.refracta, while it was thin in P. rhoeas. The cur
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The object of this research is to determine the effect in the differences of the correlation pattern of the micro blogging on the educational attainment of computer science curriculum for 12th grade students. I will try to test the best suited correlation and I might use the demo curriculum as well to achieve its objectives , The research method that will be used in this research is the quantitative method where we will use a sample of 60 students divided into two groups ( correlate the micro blogging - adopted the sequence pattern of relating the micro blogging) As a result, we found out that there are quantitative differences among the two groups' median , The differences goes back to the main effect of the correlation pattern of the m
... Show MoreThe Boltzmann transport equation is solved by using two- terms approximation for pure gases . This method of solution is used to calculate the electron energy distribution function and electric transport parameters were evaluated in the range of E/N varying from . 172152110./510.VcmENVcm
From the results we can conclude that the electron energy distribution function of CF4 gas is nearly Maxwellian at (1,2)Td, and when E/N increase the distribution function is non Maxwellian. Behavior of electrons transport parameters is nearly from the experimental results in references. The drift velocity of electron in carbon tetraflouride is large compared with other gases
The research aims to verify that there is an influence between innovative marketing and the organization's reputation by brand mediation.
The research problem is that the Oil Marketing Company (SOMO) needs innovative, unconventional methods in marketing its products and improving its reputation by adopting a solid brand that adds value to the product.
The importance of the research: The importance of the research is highlighted as it deals with essential variables in business organizations that help increase customer loyalty by adopting a distinctive brand.
The research started from four main hypotheses to explore correlations and influence between researc
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