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.
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The present study aims to identify the role of behavioral disorders (anxiety disorder, behavior disorder "behavior", confrontation and challenge disorder, aggressive behavior) in predicting bullying patterns (verbal, physical, electronic, school) in a sample of adolescents with autism spectrum disorder. For this purpose, the researcher developed scales to measure the behavioral disorders and the bullying patterns among adolescents with autism spectrum disorder. The researcher adopted the descriptive survey approach. The study sample consists of (80) adolescents with autism spectrum disorder with ages range from (15-19 years) and (45-53 years old) in association with israr association for people with special needs in the northern borders
... Show MoreThe Wonderful Wizard of Oz and Peter and Wendy present universal ideas that exist in all times, despite being written in the beginning of the 20th century. Among the most significant ones is the concept of “home”. The article discusses the essentiality of the idea of “home” where the identity of an individual shapes, and where one’s spiritual, psychological, and physical being develop. It also studies the attitudes of each protagonist towards the concept of ‘home’ based on their understanding of it and according to their gender differences. The characters in both stories tread on the path of perplexity between leaving their homes and returning to them. Peter’s world is the world of imagination while Doro
... Show MoreObjective(s): To evaluate teachers’ performance of counseling for pupils with Attention Deficit and Hyperactivity Disorder, to identify the relationship between Teachers’ Performance of Counselling for Pupils with Attention Deficit and Hyperactivity Disorder and their demographic.
Methodology: A quasi-experimental (pre-posttest) design was carried out to evaluate teachers’ performance of counseling for pupils with Attention Deficit and Hyperactivity Disorder, at Al-Firdous mixed primary School and to find out the association between teachers' performance about Attention Deficit and Hyperactivity Disorder and their socio-demographic characteristic. The study was started from 18th September 2
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This study aims to identify the impact of using the infrastructure of the Information Technology (IT) on the performance of human resources in the public universities. This process is done by doing research in the size, quality, and efficiency of the performance, also speed of achievement and simplification of procedures. Diyala University was chosen for the diagnosis through the opinions and attitudes of its employees. Consequently, suggestions that contribute to improve the performance of the employees and thus its overall performance are obtained. Another objective of this study is identifying the human resources which are currently used in academic institutions and educational services systems because the significant role of th
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The value of time out as a time not count of official time form the game like four periods and extra time also it considered a great interest if used well thru the game , the importance of this problem is not using well the time out and when the coach ask for time out and how to invest this time legally to make good results also there is no observing system as the researcher see gives the reality image that the coach is successful lead the game when he takes time out . The goals of research that knowing on numbers of time out for excellent teams in Iraq (first &second) stages and putting special inventory reverse reality of asking time out (positive &negative) on playing basketball , the hypothesis of research that tell the time out effect
... Show MoreKey words:Jasminumsambac, Volatile oil, Antioxidant.
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The design was distinguished in Late Twenty-First Century With new and new methods Through which the ability to adapt all technical media in the formation of two-dimensional and three-dimensional figures and shapes was achieved .
Which led to the emergence of endless sets of design ideas characterized by the heterogeneity of design forms and design solutions that preceded it. The designer could not access these creations in various architectural and artistic fields only through computer programs, especially those related to the activation of mathematical logic and what is known as algorithms in the formation and construction of the form, which led to the emergence of the "parametric direction" and the problem of research is summarized