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.
Abstract
The research seeks to shed light on green accounting information systems, analyze them, identify sustainability reporting and how to improve it, as well as study the importance of the Iraqi oil sector, analyze it, and work on applying green accounting information systems in order to improve the quality of sustainability reporting. Oil as a branch of the General Corporation for the Distribution of Oil and Gas Products to apply the practical aspect and prove the hypothesis of the research. Explaining the company's role in improving environmental conditions
Several studies have indicated an unprecedented increase in the number of Arab youth who watch music videos. It is also a custom in Arab countries to broadcast songs at their happy parties such as weddings, engagements and birthdays. We see that guests and party owners interact by dancing and singing with the songs, while the viewership rates of Arab music videos have reached millions on YouTube. The researcher decided to study the image of women through the lyrics of these songs, due to their importance in shaping the image of women in the minds of young people and shaping the (self-image) of young women. Twenty songs were selected from the most watched songs on YouTube for the year 2024, and it was found that the negative qualities of t
... Show MoreThe study aims at finding out the effect of the lead time strategy on the first intermediate class pupils' achievement in geography The partial experimental design of two groups, experimental and control, with pre-post tests is used. The sample is represented in (73) female pupils. The sample is divided into two groups (37) experimental group and (36) control one. The sam ple is selected from first intermediate class pupils ( Al Batol intermediate school for girls) Baghdad Al-karkh-3, for academic year 2015-2016 The researcher has equalized the two groups in several variables: the previous achievement tests, intelligence, age in months, the scores of geography test of first course
In this research we investigated the corrosion behavior of the commertialy pure titanium and Ti-6Al-4V alloy that coated with hydroxyapatite by electrochemical deposition with applied voltage (6,9,12) Volt from aqueous solution containing Ca(NO3)2.H2O =7.0 gm/l , (NH4)2HPO4 =3.5 gm/l , Na(NO3)2 = 8.5 gm/l in order to improve the bonding strength of hydroxyapetite and medical metals and alloys and increasing the biocompatibility. The coating layer morphology was investigated by XRD, Optical microscope , and SEM tests, the corrosio tests was made by use senthesys simulated body fluid (SBF) , and we found that the propreate voltage for coatint on Ti was 9 Volt and for Ti-6Al-4Vwas12Volt.
تكمن أهمية البحث من الاستفادة من تمرينات الخاصة بمساعدة استعمال أي جهاز تدريبي مثل استعمال جهاز (Vertimax) فإِنَّ هذهِ التدريبات تساعد في تطوير التحمل الخاص وفقًا لما يتطور من قدرات بدنية باستعمال هذا الجهاز، ومن هنا برزت مشكلة البحث انه من المهم للاعب ان يعمل على الروافع الجسم للحصول على اداء افضل في عملية الرمي والحصول على افضل انجاز لهذة الفعالية باستعمال جهاز تدريبي جديد حيث يسلط مقاومات متعددة في ان وا
... Show MoreAtotal of 75 different clinical samples were collected from different hospitals in Baghdad Biochemical and morphological characterization tests showed that forty isolates were identified as Staphylococcus aureus Antibiotic susceptibility tests of all isolates towards ten antibiotics were carried out and results showed that many isolates (97.5 %) were resistant to ?-lactam antibiotic , 70 % were resistant to Tetracyclinee , 62.5% were resistant to co-trimoxazole , 60 % were resistant to ciprofloxacin , 55% were resistant both of chloramphenicol and erythromycin , 52.5% were resistant to gentamicin , 35% were resistant to rifampicin , 10% were resistant to vancomycin . According to the above results the S.aureus I1 which is isolated
... Show MoreObjective: to assessthe impact of psychological and social climacteric changes on quality of life among
middle age women in Baghdad city
Methodology: : A descriptive analytic study was conducted to study the quality of life among middle age
women due topsychological and social climacteric changes from February 2013- July 2013. A purposive
sampleconsisted of three hundred (300) womenaged (40-65) years who were attending health centers in two
sectors in Baghdad / AL- Russafa andAL- karhk . The data were collected through using interview technique ,
and questionnaire format , which comprises two parts, first part consist (socio-demographic characteristic , the
second part quality of life domains (psychological and socia
The research aims to identify motivated to join the Evening Studies students to the College of Education at the University of Tikrit sections. In addition to knowledge of the differences in the degree of motivation of students according to gender, specialty, educational stage. To achieve the objectives of the research scholar us a measure consisting of (34) paragraph formulated positively, have been applied to a stratified random sample strength (500) students.
The results showed that the degree of motivation was very big on all areas of the college and class, reaching the percentage of response (84.3%), and professional motives came first prize as a percentage of (93.8%), in addition
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Abstract
This study aims to identify the degree to which the first cycle teachers use different feedback patterns in the e-learning system in addition to the differences in the degree of use according to specialization, teaching experience, and in-service training in the field of classroom assessment, as well as the interaction between them. The study sample consisted of (350) female teachers of the first cycle in government schools in Muscat Governorate for the academic year 2020/2021. The study used a questionnaire that contained four different patterns of feedback, which are reinforcement, informative, corrective, and interpretive feedback. The psychometric properties of the que
... Show MoreThe aqueous extract of Citrullius colocynthis dried seeds (160 ?g/ml) was in vitro evaluated for its effect on phagocytic index (PI) and lymphocyte transformation index (LTI) of blood cells obtained from 30 apparently healthy blood donors (15 males and 15 females). The PI was further in vivo evaluated in cells of peritone, spleen and liver of mice treated with the extract at a dose of 0.64 mg/kg. The results revealed that in in vitro study, phagocytic cells treated with the extract showed a significant increased percentage as compared with untreated cells (60.0 vs. 44.1%). Phagocytes obtained from peritone (44.1 vs. 30.0%) and spleen (45.6 vs. 39.6 %) of treated and untreated mice behaved in a similar manner, while liver phagocytes showed n
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