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 research aims to know the role of transformational leadership in the organizational success of the College of Education at Samarra University. The researcher adopted the analytical descriptive method in analyzing the research problem. The research included two main hypotheses that resulted in four hypotheses that were subjected to statistical tests. A sample of (54) The researcher used the survey method as a main tool for collecting data and information as well as visits and structured interviews that took place during the period of application. The research reached a set of conclusions and recommendations among the conclusions that there is an art relationship There is a strong and moral impact between transformational lead
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Metaphor is a linguistic phenomenon related to people's cultures. It is an integral part of cultural heritage. This paper tackles the use of animal-based metaphors in the field of football club titles so as to draw comparisons between those in Russian with their counterparts in Arabic. Names of animals are used to refer to some clubs and teams, where these names or titles reflect animal features such as strength, preying on victims; or animal figures are employed in the club symbols, or due to the similarity of the club shirt to the animal outer shapes in colours. For instance, "an-Nawaris", which means gulls in English, is used to refer to az-Zawraa club du
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Decision-makers in each country work to define a list of internal and external interests, goals and threats to their countries according to the nature of their awareness of these interests, goals and threats.
Hence, Iraq is not an exception to this rule, and the process of evaluating its interests and the objectives of its foreign policy is subject to the pattern of awareness of decision-makers and the influencing forces in defining its basic interests, which often witness some kind of difference in defining them, evaluating their importance and determining the size of the threats they face. And among these interests and threats that have witnessed a difference in the assessment of their
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The child realize that the meals time provide golden opportunities to get the attention the child needs. However, many difficulties that may appear about eating food can be avoided, if the family used the right way in dealing with this problem. The study aims, in this case, at searching for the reasons that lies behind the child's obstinacy in eating his food and the attempt to study some variables that is related to the research topic.
The results are summed up as follows:
- The number of the sample children is 3 of both sexes between the ages of 3 to 6 years
Objectives: Dickkopf-1 (DKK-1) is WNT/b-catenin pathway antagonist which plays a detrimental role in the development of diabetic retinopathy (DR). This research aimed to assess serum DKK-1 levels in diabetic patients who have and have not developed DR and, compare them with the control subjects finding out whether we can use it as an indicator for DR early diagnosis and to find out which one of the widely used two groups of antidiabetic treatments had the greater effect on this biomarker and hence on the progression of DR. Methods: The study participants were divided into two subgroups: First, 70 patients (36 male, 34 female) with type 2 diabetes mellitus, among them 35 patients diagnosed with DR and 35 with no evidence of DR, and s
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A new method, simple and sensitive was utilized in determining mebeverine – HCl (MB-HCl) (3, 4-Dimethoxy benzoic acid ethyl 2, 4 methoxy4-phenyl-1-methyl ethyl amino-butyl ester) in pure and pharmaceutical formulations via utilization this multiple continuous flow cell. The method is dependent on genesis for complex of ion pair(4-((3, 4-dimethoxybenzoyl) oxy)-N-ethyl-N-(1-(4-methoxyphenyl) propan-2-yl) butan-1-aminium-2-hydroxy-3,5- dinitrobenzoate) among mebeverine–HCl (MB-HCl) and 3,5-Dinitrosalicylic acid (3,5-DNSA) in ammonium acetate middle to configure a whiteish yellow precipitate compound via utilizing multiple continuous flow cell that works as a solo flow cell with 4S×3 – 3D analyzer. Optimum parameters were studied to rai
... Show MoreThe research aims to show the possibility of adopting the market approach to measure the fair value of biological assets in Iraq, by applying to a sample of the company listed on the Iraq Stock Exchange, where the Middle East Fish Production and Marketing Company was selected from among 7 companies representing the agricultural sector in Iraq, and according to the availability of data and for five years, the financial statements were presented of the measurement and disclosure of biological assets at fair value according to the market approach, One of the most important conclusions reached by the researcher is the The possibility of measuring and disclosing biological assets at fair value according to the market approach in the Ira
... Show MoreHR Al-Hamamy, AA Noaimi, IA Al-Turfy, AI Rajab, Journal of Cosmetics, Dermatological Sciences and Applications, 2015