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.
This research highlights one of the most important issues that have been controversial between Islamic schools, which is the duality of Intellect and Revelation and the nature of their relationship, in two core points:
The first point: Could there be a real conflict between Intellect and revelation? While the school of hadith view that this assumption is a rational assumption that does not real as long as the revelation is correct and the Intellect is clear, and that what is claimed are due to other Intellect s, we find that the Ash’ari school adopts the saying that the real conflict may occur, but rather confirms its occurrence.
The second point: For whom is the priority, for the Intellect or th
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The results showed that the organic fertilizer mixture (1:1) 30 tons/ha with chemical fertilization recorded the lowest level of bulk density of 1.2 g/cm3, the organic fertilizer mixture (1:1) 30 tons/ha with chemical fertilization recorded the highest percentage of aggregation stability amounting to 16.17%, the organic fertilizer palm fronds recorded the highest level of ready water with an average of 5.50 cm3/cm3 and the organic fertilizer mixture (1:1) 30 tons/ha without chemical fertilization recorded the highest level of ready water as it reached 6.93%, the or
... 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 MoreA new, simple and sensitive method was used forevaluation of propranolol withphosphotungstic acidto prove the efficiency, reliability and repeatability of the long distance chasing photometer (NAG-ADF-300-2) using continuous flow injection analysis. The method is based on reaction between propranolol and phosphotungstic acid in an aqueous medium to obtain a yellow precipitate. Optimum parameters was studied to increase the sensitivity for developed method. A linear range for calibration graph was 0.007-13 mmol/L for cell A and 5-15 mmol/L for cell B, and LOD 207.4792 ng/160 µL and 1.2449 µg/160 µL respectively to cell A and cell B with correlation coefficient (r) 0.9988 for cell A, 0.9996 for cell B, RSD% was lower than 1%, (n=8) for the
... Show Moreفي هذا العصر - الذي داهمت في الأخطار لغة الفصاحة والبيان - يبقى القرآن الكريم أعظم حافظ للغة السليمة ، وأكبر معين لأهلها للحفاظ على ثرائها وبلاغتها ، فهي باقية ببقائه ما بقي الليل والنهار .
وهذا البحث يدور حول حفظ القرآن الكريم وأثره على لغة الطفل، ويتكون من مقدمة : وفيها بيان أهمية الموضوع ، وخطة البحث ، ومنهجه، وثلاثة مباحث:
المبحث الأول : فضل حفظ القرآن الكريم ، وفوائد حفظه إجمالاً ، والمبحث الثاني :
... 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 study attempts to measure the level of shyness; the level of psychological isolation; to identify the relationship between shyness and psychological isolation; and to identify the differences between shyness and psychological isolation among first-intermediate students. To this end, a random sample comprised (187) male and female students was chosen for the academic year (2016-2017) from Baghdad \ Al-Rasafa. To measure the shyness and psychological isolation, the researcher designed two scales: one to measure the shyness composed of (37) items divided into four domains; and the other to measure the psychological isolation made of (56) items divided into three domains. The study concluded that the sample has a medium level of shyness;
... Show MoreThe aim of the research is try to answer the questions about the importance of the participation of scientists in the scientific researcher Google Scholar for the professor and the university, and the extent of participation of Iraqi universities, and the rank of the University of Qadisiyah, and the number of participants and teachers of this engine, The research came out with several conclusions, the most important of which is that (21%) of university professors are involved in the google engine and most of the participants did not carry their full research through the site
Objectives: The study aims to identify the effects of an educational program on patients’ knowledge about vascular access care and to find out the relationship between patients knowledge scores and their selected demographic variable. &
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