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 persons who Allah Ioves them in the holly Quran
Objectivity Study0Dr 0muyad Turky Ali
Allah men tioned in Auran the loving of benevolent and who Allah loves him gave him everything 0the loving of benevolent came fist and after that the loving of justice who remove injustice and after that loving purified and in noeent 0After that mentioning loving of Knighters ( fighters )The eharity with money and to clear up the justice and loving purified is a reason of accessing paradise 0
The research deals with metaphors as being one of the primary means used by Lyudmila Ulitskaya when writing the novel " Sincerely Yours Shurik ", to form diverse and multifaceted collective female images of representatives of the classic psychological patterns presented in the work. This research reflects the results of the study related to the work of Lyudmila Yevkinevna Ulitskaya, an actress of modern Russian prose. The novel "The Sincerely to You Shorek" is one of Ludmila Ulitskaya's creations (the year of writing - 2003), which, like her other works, is distinguished by a unique presentation style, rich vocabulary, lexical and semantic diversity, and a special style of writing. writer. The main objective of the research is to look at th
... Show MoreBlastocystosis is symptomatic infection caused by the protozoal parasite Blastocystis , which resides in the intestinal tract of its hosts and it is one of the most common parasites reported in humans. It’s prevalence ranges between (30 - 50%) of the population in developing countries. This genus has a worldwide distribution and often the most commonly reported human intestinal protozoan in children and adults, even infect infants
Most countries in the world particularly developing countries, including Iraq, facing extremely dangerous problem with social and political dimensions, which is the emergence of the food crisis problem ,the decrease in domestic food production in Iraq isn't meet the needs of its population food, due to the fact that the agricultural sector suffers from multiple natural ,economic and human problems .It is still below the level required to meet the needs of the population of food ,since food at the forefront of priorities needed by the human . This represents indispensable basic necessity , so the responsibility of its availability permanently in appropriate&nb
... Show MoreUrban land uses are in a dynamic state that varies over time, the city of Karbala in Iraq has experienced functional changes over the past 100 years, as the city is characterized by the presence of significant tourist and socio-economic activity represented by religious tourism, and it occur due to various reasons such as urbanization. The purpose of this study is to apply a Markov model to analyze and predict the behavior of transforming the use of land in Karbala city over time. This can include the conversion of agricultural land, or other areas into residential, commercial, industrial land uses. The process of urbanization is typically driven by population growth, economic development, based on a set of probabilities and transitions bet
... Show MoreThe aim of this research is to construct an educational program in light of the theory of behavioral cognitive and its impact on the development of the efficient response to students affected by crises (centers of your right to education). To achieve the objectives of the research, two scales were developed by the researcher in addition to two equivalent hypotheses were formulated. The scale contains (26) items divided into five fields; for its validity and reliability were derived based on the measure of efficient response, an educational program based on the theory of behavioral cognition. The test and the educational program were applied to a sample of (60) students from the centers of your right to education, divided into experimenta
... Show MoreThe current research aims to train students to take benefit of their studies to analyze and taste the artistic works as one of the most important components of the academic structure for students specializing in visual arts; then to activate this during training them the methods of teaching. Consequently, the capabilities of mind maps were employed as a tool that would be through freeing each student to analyze a model of artistic work and think about his analytical principles according to what he knows. Then, a start-up with a new stage revolves around the possibility of transforming this analysis into a teaching style by thinking about how the student would do. The same person who undertook the technical analysis should offer this work
... Show MoreIn order to evaluate the performance of introduced varieties of maize and test them under different levels of plant density, and to determine which of the introduced varieties give a high yield and at what plant density, a field experiment was carried out at Station A in the Department of Field Crops- College of Agricultural Engineering Sciences - University of Baghdad- Jadiriyah, for the fall season 2021, the RCBD design was used with four replications, in a split plot arrangement, the three plant densities (50.000, 70.000, and 90.000 Plant s ha-1) were the main plates, while the varieties represented the secondary factor, which is six varieties of maize, class 2 = 5783 DKC, Class 3 = 6315 DKC, Class 4= 6590 DKC, whic
... Show MoreABSTRACT: Pathogenic bacteria responsible for the causation of many common diseases have been identified on currency notes. The present investigation was carried out on one hundred currency notes of all the denominations (50, 100, 250, 500 and 1000RY), obtained from different occupational mainly bus drivers, hawker street, vegetable vendor, restaurants and butchers and fish seller groups in Taiz city,Yemen. Identification and characterization revealed active participation of the following species of organisms in the ascending order of percentage as E. coli(50.28 %),Staphylococci aureus(14.04 %), Klebsiellaspp(4.39 %),proteus(4.39 %), salmonella(1.25 %), shigella(0.72 %), Coagulase negative staphylococcus(0.60 %), pseudomonas(0.50 %),
... Show MoreGlorify and Praise be to God, and prayers and peace be upon the Messenger of God, his family, companions, and those who are loyal to him.
The subject derives its significance from two important sources , the first one lies in the Sunnah of the Prophet, while the other is the family source , which enrich this subject with great importance.
As for the objective of the topic, it shows to the reader the prophetic bases that mitigate and ease the burden of the husband in a way that secures the marital happiness, so that the Muslim woman takes it as a path for her in life and a slogan that illuminates the darkness of the path and makes her to overcom
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