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 aim of the current research is to identify the level of organizational culture among the headmasters and teachers of intermediate and secondary schools in Arar city. It also aims to identify the effect of job variables, qualifications, educational stage, and years of experience on the level of organizational culture and its domains. The research sample consisted of 62 participants divided into 7 headmasters and 55 teachers. The researcher used the questionnaire of the organizational culture. The researcher used also statistical methods such as mean, standard deviation, t-test, and One way ANOVA. The results revealed that the level of organizational culture and its four domains were high, and there was no effect of the variables (teac
... Show More
Faces of the individual in his life many stressful events, which includes expertise undesirable, and events may involve a lot of sources of tension and the risk factors and threats in all areas of life, and this would make the stressful events play a role in the genesis of many diseases physical.
The high blood pressure is one of the most Actual manifestations of mental stress in the present scale physical disorders which may frequently in men relative to women, which may be caused by spasms in the blood vessels.
Urban wetlands are one of the complex systems that provide many economic, social and environmental services to the city. In this research, the most important services provided by urban wetlands from the point of view of the urban planner were reviewed, and the types of these lands and their divisions according to the type of services provided by each type were presented. Environmental is represented in its ability to reduce the dangers of floods, mitigate the climate and reduce its negative impacts, purify water and deplete a lot of suspended impurities and pollutants, and social services such as recreational areas and beautiful landscapes that inspire joy and reassurance in the soul, as well as cultural areas and sports activities for m
... Show MoreA study that collected 240 samples and divided into two groups: the first 120 samples were for diabetics and the second 120 samples were for healthy people, and each group included (90, 20.10) samples from the mouth, urine and vagina respectively, The results showed positive (28.67, 4.00, 1.67) isolates of Candida. In the mouth, urine and vagina, respectively, of diabetic patients compared to (9.33, 2.33, 5.00) positive isolates in the mouth, urine and vagina, respectively, in the healthy. The rate of positive isolates in women was high in women with diabetes and healthy, and it reached 25.33 and 9.00 isolates, respectively, compared with the rate of isolates in men with Candida disease for diabetic patients and healthy people 14.67 and 2.0
... Show MoreThe current research aims to evaluate the level of inclusive leadership within the General Secretariat for the Council of Ministers, and its role in achieving integration in work through the need to improve relationships between different administrative levels, facilitate participation, expression of opinions, and belonging to the organization. In order to achieve the research objective, the descriptive analytical statistical method was chosen using the SPSS V.25 programs, with various statistical methods and measures, including mean, standard deviation, variance coefficient, relative importance, and simple regression, through a questionnaire tool for data collection. The research community included the leadership in the sample of resear
... Show MoreThe present study aimed to identify the availability of the National Council of Teachers of Mathematics (NCTM) standards in the content of mathematics textbooks at the basic education stage in the Sultanate of Oman. The study used the descriptive-analytical approach, adopting the method of content analysis through using a content analysis tool that included (43) indicators distributed on the four NCTM standards related to the field of geometry, after verifying their validity and reliability. The study population consisted of mathematics textbooks (first and second semesters) for ninth-grade students in the Sultanate of Oman in the academic year 2018/2019, while the sample consisted of Geometry units in the content of those books, which a
... Show MoreThe messages are ancient method to exchange information between peoples. It had many ways to send it with some security.
Encryption and steganography was oldest ways to message security, but there are still many problems in key generation, key distribution, suitable cover image and others. In this paper we present proposed algorithm to exchange security message without any encryption, or image as cover to hidden. Our proposed algorithm depends on two copies of the same collection images set (CIS), one in sender side and other in receiver side which always exchange message between them.
To send any message text the sender converts message to ASCII c
... Show MoreAim of the research is the study of improving the performance of the thermal station south Baghdad and the main reasons for reduced its efficiency. South Baghdad power planet comprises (6) steam turbine units and (18) gas turbine units .The gas turbine units are composed of two groups: the first group is made up of gas units (1,2), each of capacity (123) MW. The design efficiency of gas turbine units is 32%. The actual efficiency data of steam units is 18.3% instead of 45% which is the design efficiency. The main reason for efficiency reduction of gas units is the rejected thermal energy with the exhaust gases to atmosphere, that are (450-510) ℃.The bad type of fuel used (heavy) fuel. Another reason for the low efficiency and has a neg
... Show MoreThe article reflects the results of the analysis of the use of metaphors as one of the main means used by Lyudmila Ulitskaya when writing the novel “Sincerely Yours Shurik” to form the image of the main hero in the novel. The main purpose of the article is to consider metaphors, which helped the author to form the image of the main character Shurik in the text space through the stages of his life path, closely related to the people around him, who is always happy to be useful (hence the title "Sincerely Yours"), among which the female images of his relatives, girlfriends and others stand out as a special layer in the narrative. And in the course of the study, the following tasks were solved: the metaphors that make up the image of the
... Show MoreCo-composting process can be acquired by combining organic fraction of municipal solid waste (OFMSW) with sewage sludge (SS) and mature compost (MC) as enhancement and bulking agent to overcome the problems of municipal solid waste and wastewater treatment plants besides the finally produced fertilizer usage for agriculture and horticulture. The effects of different mixture ratios of (OFMSW), (SS) and (MC) on the performance of composting process were investigated in this study. Piles of about 10 kg were prepared by mixing OFMSW, SS and MC in three different ratios (w/w) [OFMSW: SS: MC= 3:1:1, 3:2:1, and 3:3:1]. Results showed that the pile [3:1:1] was most beneficial to composting. The final compost products contained a
... Show More