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.
Electric Quadrupole transitions are calculated for beryllium isotopes (9, 10, 12 and 14). Calculations with configuration mixing shell model usually under estimate the measured E2 transition strength. Although the consideration of a large basis no core shell model with 2ℏtruncations for 9,10,12 and14 where all major shells s, p, sd are used, fail to describe the measured reduced transition strength without normalizing the matrix elements with effective charges to compensate for the discarded space. Instead of using constant effective charges, excitations out of major shell space are taken into account through a microscopic theory which allows particle–hole excitations from the core and model space orbits to all higher orbits
... Show MoreIn many oil fields only the BHC logs (borehole compensated sonic tool) are available to provide interval transit time (Δtp), the reciprocal of compressional wave velocity VP.
To calculate the rock elastic or inelastic properties, to detect gas-bearing formations, the shear wave velocity VS is needed. Also VS is useful in fluid identification and matrix mineral identification.
Because of the lack of wells with shear wave velocity data, so many empirical models have been developed to predict the shear wave velocity from compressional wave velocity. Some are mathematical models others used the multiple regression method and neural network technique.
In this study a number of em
... Show MoreThe purpose of this study was to investigate the effect of six thinking hats on creative thinking among 10th grade female students in Tulkarm district. The sample comprises two sections of 10th grade female students (n=80) in Adawiya secondary School, The two sections were divided into two groups; one as an experimental group which works with six thinking hats, and the second as control group that learns traditionally. Creative thinking exam was used to measure the creative thinking with reliability (0.88).
The results of the study have shown the following:
There were statistically significant differences at (α ≤ 0.05) in the creative thinking among 10th grade female student
... Show Moreالكتابة عن الأندلس بعد تسليم مدينة غرناطة يحمل في ثناياه ألم كبير، لأن الأندلسيين عاشوا تجربة إنسانية قاسية سببها الأساس غياب التسامح الديني والعدالة الاجتماعية، الأمر الذي دفعهم للثورة مطالبين بحقوقهم التي نصت عليها معاهدة تسليم المدينة. فقد عاش أولئك حياة صعبة ، فكانوا صورة للصراع بين حضارتين الإسلامية والغربية ، ويمكن تلمس ذلك الصراع من خلال دراسة ثوراتهم ضد السلطة الحاكمة التي يبدو من تتبع أح
... Show MoreIn this article it is proved experimentally that the photon is a particle that has mass and constant wavelength by explaining the effect of refractive index on the wavelength and the natural mass of photon. It is very difficult to measure the mass of photon, a simple and easy process was proposed in this paper to calculate the mass length of photon in vacuum (Y) and in medium (Y*), by measuring the length of laser beam in air (Lair) and in medium (Lmed). A new method was postulated to calculate refractive index by using these relations (n = Y*/Y), and (n = Lmed / Lair) which supposed a new theory of light.
Abstract
This research aims to improve the provided health service level inside Baghdad hospitals and the Yarmouk educational, as well as to shed light on the reality of the health service and the quality within the major operations room in both hospitals, as the operations room represent the research community, as was the use of some quality tools Pareto and Ishikawa diagram to measure and assess the level of quality provided, and include research problem to find out what are the problems and obstacles facing the process of improving quality in both hospitals, and whether there are scientifically accurate method to assess the quality of health service in Baghdad's Yarmouk hospital and educational . Where the researcher h
... Show MoreThe current study aims to identify the effect of guided visualization strategy in developing the visual perception among kindergarteners. The experimental design was used; pre-post test. A total of (32) boy and girl ranging 5 to 6 years old were selected from al-Rabeea’ kindergarten, directorate of al-karkh 2 / Baghdad. The sample divided into equal two group (16) boy and girl of each one. al-Talaqany’s (2016) visual perception skills test among kindergarteners was adopted to collect the required data. The collected data had processed based on (gender, pre-post test, and age). To achieve the objectives of the study; the researcher set up series of sessions that addressed the guided visualization strategy among kindergarteners compose
... Show MoreAbstract
The study aims to know the degree of secondary school managers' practice of servant leadership in Gaza from their teachers’ perspective. It further aims to examine whether there are any statistically significant differences at (α 0.05≥) between the means of the study sample’s members attributed to variables such as (gender, educational qualification, and years of experience). To achieve the objectives of the study, the study adopted the descriptive survey method, using a questionnaire consisting of (30) items distributed to four domains: (workers service, ethical dealing, motivation & influence, and building an organized, integrated society). Then, the questionnaire was distributed to t
... Show MoreThe present study aims to identify the effectiveness of deductive group patterns in developing the creative thinking of second-intermediate-grade pupils in history discipline. The current null hypothesis has been investigated: There are no statistically significant differences at (0.05) between the scores mean of the experimental group pupils who were taught according to the deductive group pattern and the scores mean of the control group pupils who were taught according to traditional method in creative thinking testing. the study sample was divided into two groups: an experimental group of (30) female students and a control group of (31) female students. The two groups are equalized based on the variables of age, the scores of the firs
... Show MoreThe emergence of the Internet and its transformation in the early nineties of the last century led to a means of mass communication that brought about significant structural changes in the media map.
Over the course of historical development, the public did not engage the media in its behavior in the implementation and dissemination of an idea, generalization or theory put forward by media experts or practitioners through these means to do it. Blogs represent the most important service provided by the Internet in recent years which has gained special importance in the media field. Where the word “Blogs” has several names: (alternative media), (blogging press), (popular press) and other names.
The medi
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