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 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.
The 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 Battle of Kadesh is replete with many military arrangements that reflect the tremendous development of war preparations in the thirteenth century BC; where the expressive pictures the Egyptians left on some of the walls of their temples show the tremendous ability to organize and divide the forces and the great development that affected the war machine. Furthermore, the text accompanied these pictures reveal some news about that battle, which is considered one of the most important wars in the ancient world. Thus, the importance of the study lies in the fact that it examines one of the most important battles of the ancient Near East, the results of which had great repercussions on the region. This is because it is the most abundant B
... Show MoreThe current study is concerned with presenting a descriptive study of the history of the city of Astrabath in the sixth century AH. The problem that the research tried to answer is represented in the investigation of historical news, and the study of the most prominent cultural aspects which characterizing that city. The research also aims to reach the geographical location of that city, its name and its suburbs. The importance of the research lies in the knowledge of everything related to the role of the civilization of Astrabath, as well as tracing the entry of the Arabs to it, so that it became a cultural, economic and scientific center and its historical role in the sixth century AH. The research reminde us with the scientific role o
... Show MoreThe objective of the research is to shed light on the nature of the impact of the activities of the national strategy for poverty alleviation in achieving the goals of sustainable development, and the research problem was represented by Is there an effect of the activities of the national strategy for poverty reduction in achieving the goals of sustainable development? and represents the field of research in the Ministry of Labor and Social Affairs For the years (2012-2016) and the results of the sustainable development goals indicators for the years (2012-2016), the ready-made statistical program (SPSS ver.10) was used to calculate the percentages, multiple linear regression equation, the F test and the R2 coefficient, and the research
... Show MoreThe auditor has a role in allocating joint costs in the gas industry, and the auditor's procedures are considered as systematic critical examination, analysis and evaluation of everything related to costs in general and joint costs in the gas industry in particular, with the aim of controlling the joint costs of gas industry products, and knowing the share of the cost of each product from the total industry costs Gas products reflect the reality of the company's performance by discovering weaknesses, defects and any errors, to ensure increased effectiveness and efficiency of the parties concerned with auditing them and imposing control and control over the company's resources, as well as
... Show MoreThe aim of this paper is to present the numerical method for solving linear system of Fredholm integral equations, based on the Haar wavelet approach. Many test problems, for which the exact solution is known, are considered. Compare the results of suggested method with the results of another method (Trapezoidal method). Algorithm and program is written by Matlab vergion 7.