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.
الحمد الله أولا واخرا وبعد .. إن الواقع الذي عايشه الناس في ظل دولة المسلمين منذ إقامة دولة الإسلام بعد بعثة الرسول الكريم (صلى الله عليه وسلم ) في المدينة ولأكثر من أربعة عشر قرنا نرى إنه عاش في كنف هذه الدولة الكبيرة من بلاد الصين شرقا وإلى وسط أوربا وجنوب فرنسا غربا العشرات من الملل و الأديان والأجناس وممن لا يدينون بالإسلام وهم كما تحفظ لهم دولة الإسلام منهم وعيشهم الرغيد فهم يمارسون شعائرهم وطقوسهم الديني
... Show More Thsst researcher problem of delays faced by researchers are all waiting to evaluate their standards by the experts who must take their views to extract the truth Virtual important step first step in building standards whatsoever, then the difference of opinion among experts about the paragraphs Whatever the scope of their functions, leading to confusion in maintaining these paragraphs or delete? Or ignore the views and opinion of the researcher to maintain the same? Or as agreed upon with the supervisor if he was a student? Especially if the concepts of a modern new building.
Therefore, the researcher sought to try to find a solution to her problem to conduct an experiment to test building steps
Background: DVT is a very common problem with a very serious complications like pulmonary embolism (PE) which carries a high mortality,and many other chronic and annoying complications ( like chronic DVT, post-phlebitic syndrome, and chronic venous insufficiency) ,and it has many risk factors that affect its course, severity ,and response to treatment. Objectives: Most of those risk factors are modifiable, and a better understanding of the relationships between them can be beneficial for better assessment for liable pfatients , prevention of disease, and the effectiveness of our treatment modalities. Male to female ratio was nearly equal , so we didn’t discuss the gender among other risk factors. Type of the study:A cross- secti
The current study aims to investigate the effect of the interaction between the use of the improve strategy in teaching mathematics and the level of academic achievement on the acquisition of algebraic concepts and habits of mind among tenth-grade students in Oman. The study adopted the experimental method, based on a quasi-experimental design with two groups: experimental and control groups and pre-post-measurement. The study sample consisted of (28) 10th-grade students as an experimental group and 26 of 10th-grade students as a control group in Al-Tufail bin Amr School in South Al Batinah. The differences in the pretest and posttest gains were analyzed using mean, standard deviation, ANCOVA, t-test, effect size (eta-square), and two-wa
... Show MoreObjective(s): to assess the effectiveness of educational program on nurses' knowledge concerning the side
effects of chemotherapy among children with leukemia.
Methodology: A descriptive analytic (quasi – experimental) design study was carried out at Baghdad City from
2
nd of October to 27th of June 2015. Non-probability sample of (35) male and female nurses was selected from
the Oncology Wards in Children Welfare, Child's Central and Baghdad Teaching Hospital. The study
instruments consisted of two major parts to meet the purposes of study. The first part is related to nurses'
demographic characteristics and the second part (four domains) is related to nurses' knowledge concerning the
side effects of chemothera
The aim of the current research is to reveal the effect of using brain-based learning theory strategies on the achievement of Art Education students in the subject of Teaching Methods. The experimental design with two equal experimental and control groups was used. The experimental design with two independent and equal groups was used, and the total of the research sample was (60) male and female students, (30) male and female students represented the experimental group, and (30) male and female students represented the control group. The researcher prepared the research tool represented by the cognitive achievement test consisting of (20) questions, and it was characterized by honesty and reliability, and the experiment lasted (6) weeks
... Show More
Efficient cuttings transport and hole cleaning are very important factors for obtaining an effective drilling operation. In an inclined and horizontal drilling, hole cleaning issue is a common and complex problem.
The scope of this research is to study the drilling parameters which affect hole cleaning in Iraqi directional wells through studying and analyzing some drilled wells ( vertical , directional (30 degree) , directional (60 degree) and horizontal ).An excel sheet is prepared to calculate carrying capacity index which represents an indicator for good hole cleaning in different sections. The study indicated through the field investigations, practical experiences and theoretical calculations tha
... Show Moreأن السياسة النقدية في العراق لم تشهد تحسناً كبيراً في دورها المطلوب
منها، وهذا يعود الى جملة من التغيرات على أدائها ودورها في التأثير على المتغيرات الأقتصادية المهمة، اذ حصلت ظروف صعبة على المستوى السياسي والأقتصادي اسهمت في أضعاف دورها في العراق. فالحروب العسكرية الثلاثة في وقت قياسي دمرت البنى التحتية للأقتصاد العراقي، وأخرت عملية التنمية الأقتصادية والبشرية لعدة عقود بسبب الأستنزاف الكبير للمو
Heat transfer around a flat plate fin integrated with piezoelectric actuator used as oscillated fin in laminar flow has been studied experimentally utilizing thermal image camera. This study is performed
for fixed and oscillated single and triple fins. Different substrate-fin models have been tested, using fins of (35mm and 50mm) height, two sets of triple fins of (3mm and 6mm) spacing and three frequencies
applied to piezoelectric actuator (5, 30 and 50HZ). All tests are carried out for (0.5 m/s and 3m/s) in subsonic open type wind tunnel to evaluate temperature distribution, local and average Nusselt number (Nu) along the fin. It is observed, that the heat transfer enhancement with oscillation is significant compared to without o
Different frequency distributions models were fitted to the monthly data of raw water Turbidity at water treatment plants (WTPs) along Tigris River in Baghdad. Eight water treatment plants in Baghdad were selected, with raw water turbidity data for the period (2008-2014). The frequency distribution models used in this study are the Normal, Log-normal, Weibull, Exponential and two parameters Gamma type. The Kolmogorov-Smirnov test was used to evaluate the goodness of fit. The data for years (2008-2011) were used for building the models. The best fitted distributions were Log-Normal (LN) for Al-Karkh, Al-Wathbah, Al-Qadisiya, Al-Dawrah and, Al-Rashid WTPs. Gamma distribution fitted well for East Tigris and Al-Karamah
... Show More