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.
This work aims to show the nature of the relationship between management by walking around (the independent variable) and strategic renewal (the dependent variable), as well as it shows the effect of the independent variable on the dependent variable. Questionnaire items were considered the main tool for data collection by three basic aspects. The first involved the personal data of the respondents, while the second included items related to management by walking in five dimensions, and the third is strategic renewal items by addressing four dimensions. The tourism sector, while the community has six Excellent grade hotels was taken into account in this wor
... Show MoreObjectives: To evaluate the effect of vitamin D3 local injections on apical root resorption, alveolar bone integrity, and chair-side time following three and six months of canine retraction. Subjects and Methods: Seventeen adult patients (18-35 years old) of class I and II malocclusions were recruited, who required bilateral maxillary 1st premolars extraction before starting maxillary canines retraction. The experimental side received 25 pg dose of vitamin D3 injected locally into the distal periodontal sulcus of the canine (before force application) every three weeks, while the control side received retraction force only. Periapical radiographic evaluation was conducted after 3 and 6 months of the start of canines' retraction. Results: At
... Show MoreWith the fast-growing of neural machine translation (NMT), there is still a lack of insight into the performance of these models on semantically and culturally rich texts, especially between linguistically distant languages like Arabic and English. In this paper, we investigate the performance of two state-of-the-art AI translation systems (ChatGPT, DeepSeek) when translating Arabic texts to English in three different genres: journalistic, literary, and technical. The study utilizes a mixed-method evaluation methodology based on a balanced corpus of 60 Arabic source texts from the three genres. Objective measures, including BLEU and TER, and subjective evaluations from human translators were employed to determine the semantic, contextual an
... Show More In this research study, I tried to trace the epic effect to learn how it was understood and how it was used. Following the descriptive and analytical approach in the research, the first chapter dealt with a presentation of the methodological framework of the problem, the goal, the limits of the research, the importance and the need for it and the definition of terms, as well as the theoretical framework which consisted of two topics, including the impact of the epic theater on the world theater and the second the effect of the epic theater on the Arab theater, This came by tracing the epic impact on the world stage of the Greeks, the Middle Ages, the Renaissance, and the Arab theater of the twentieth century.
As for the second
This study was carried out to determine the heavy metal accumulation of Juncus rigidus Desfontaines, 1798 from three different regions of the Basrah Province in Southern of Iraq. Specifically, the concentrations of lead, nickel, and cadmium were determined in the roots, culms and leaves of the plant. The results indicated that the highest accumulation of the heavy metal was recorded in lead (Pb) 12.50± 3.58 mg kg-1and then in nickel (< 0.30). The lowest value was recorded for cadmium (< 0.05). As well, lead concentrations in J. rigidus varied in different locations and parts of the plant from undetectable in control to 12.66, 19.33, and 9.80 mg kg-1 in leaves, culm, and roots respective
... Show MorePractical application is an effective tool for preparing qualified scientific and technical cadres if applied correctly and efficiently. In addition to being the complementary part of everything that has been studied in the years of study, it is a scientific linking tool between theory and application. Here lies the importance of this research in clarifying the central and important role that practical application plays in general in raising the scientific level of the student, and the extent of the suitability of the curriculum and means of practical application and the extent and needs of the students applying at the Institute of Administration - Rusafa - Department of Information Technology and Libraries. This research attempted to answe
... Show MoreThe research aims to determine the role of the practices of green human resources management in achieving requirements of environmental citizenship in the workplace, the General Company for Vegetable Oils was chosen for the application of field-side of research which represent one of the important industrial companies in Iraq, which suffers from poor Green human resources management applications, which reflected negatively on the development Environmental citizenship among Employees. The questionnaire use as a tool to collect data and information as well as field presence of the researcher, The research sample included (30) managers of departments and Division ,and through using statistical program (SPSS) the data has been analys
... Show MoreThe present paper sheds light on the psychological structure of Simha Bin Zion’s A Broken Soul. After reviewing the biography of the storyteller, it is clear that the hero of the rebellious character in the story of (A Broken Soul) is the writer himself. The storyteller directly begins to depict his psychological sufferings in his childhood days. He tells a story full of sadness and refusal of the neglect he suffered in his childhood. It is obvious that the early five years of Samha bin Zion’s life is considered a period of conflict that participated in the formation of his individual identity. The story represents an outlet for a hidden secret world buried under the layers of his consciousness. It deals with
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