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 study aimed to explore The Degree of Practicing of the Sixth Primary Social Studies’ Teachers in Iraq for the Principles of Active Learning from their Point of view
The study society consisted of 230 male and femalesocial studiesteachers’ subjects for the sixth primary grade in Al-Anbar General Directorate of Education. 160 of them were selected to represent the sample of the study with a percent of (70%) from the original society. To achieve the aims of the study, the researchers prepared a questionnaire consisting of (43) items which represented the active learning principles. The validity and stability of the tool were verified. The researchers used the descriptive approach to suit the objectives of this study. &
... Show MoreThis research deals with the form of the physical identity which is concerned with the features and characteristics that distinguish the shape of the city from other existing cities and reveal its similarity with the self (itself) and objective difference with others. Accordingly, these features must be sophisticated and variable resulting the shape of the city, while preserving the continuity of time, and eventually leads to the emergence of the whole shape. Physical identity is conceptually equivalent with the terms "personality" and "sense of place". The research determined the criteria for evaluating the physical identity as follows:
... Show MoreAttitude is an important subject that has attracted researchers and thinkers in organizational theory and organizational behavior because of its great importance in various field studies. Field evidence suggests that individuals in their daily lives or careers respond to specific events through a set of internal tendencies Internal tendencies are negative or positive and systematic. These trends tend to be invisible, not limited to certain boundaries, and involve a significant number of individuals within organizations or society.
The research aims to identify the impact of trends in the ethics of public service workers for individuals, through a sample of (72) doctors and (60) administrative staff
... Show MoreExperienced economic environmentRadical changes at the end of the last century and the beginning of the present century, resulting in new concepts and expectations in all aspects of economic, political, social and even behavioral.Each of these concepts is the result of rapid developments in the intangible space. Competition is no longer limited to the mere possession of tangible material resources, but because of its link to knowledge and technology content and to the comprehensive quality standards and efficient and effective policies of States. With the increasing pace of growth and interdependence among the global economies, this resulted in the birth of a new economic system led by technological development and financial liberalizati
... Show MoreIn this study new derivatives of O-[2-{''2-Substituted Aryl (''1,''3,''4 thiadiazolyl) ['3,'4-b]-'1,'2,'4- Triazolyl]-Ethyl]-p- chlorobenzald oxime (6-11)have been synthesized from the starting material p-chloro – E- benzaldoxime 1.Compound 2 was synthesized by the reaction of p-chloro – E- benzaldoxime with ethyl acrylate in basic medium. Refluxing compound 2 with hydrazine hydrate in ethanol absolute afforded 3. Derivative 4 was prepared by the reaction of 3 with carbon disulphide, treated of compound 4 with hydrazine hydrate gave 5. The derivatives (6-11) were prepared by the reaction of 5 with different substitutesof aromatic acids. The structures of these compounds were characterized from their melting points, infrared spectroscopy
... Show MoreThe current research aims to identify the level of extension of the sense of self and the cognitive style (complexity - simplification) among university students, as well as the significance of the difference according to gender (males - females), as well as the correlation between the two variables, and in order to verify this, the researcher has constructed The measure of the extension of the sense of self based on the theory of Alport 1961, as the number of its final paragraphs reached (28) paragraphs, and the cognitive style scale (complexity - simplification) prepared by (Abdullah 2017) was adopted, as the scale consisted of (32) paragraphs in its final form. To verify their psychometric properties, and the two tools were applied to
... Show MoreThe study aimed to identify the degree of availability of design Thinking Indicators in The content of the Arabic Language Curricula at the secondary stage in the Syrian Arab Republic; to achieve the goal of the study. The researcher used the Descriptive Approach based on the analysis method according to the Cognitive Theory. The study tools consist of a list of Design Thinking Indicators and a Content Analysis Tool. The researcher completed the Validity and Reliability procedures for the tools. After applying them, the results of the study resulted in the following: Greater Interest than other sub-skills. The results also showed a Divergence of care for the sub-skills and the Difference in their recurrence rate, and the Omission of some
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The entities responsible for regulating the financial market are seeking to provide high quality accounting information, to provide appropriate protection to investors, and thus encourage them and attract them to increase their investments. the research reached several conclusion, the most prominent of which comes :-
1-The production of high quality accounting information reduces investment costs and costs of processing accounting information.
2- The production of high quality accounting information helps investors identify the best investment opportunities.
3- The results of the statistical analysis showed that there is significant
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The current research aims to identify the level of organizational relaxation among the employees of educational directorates in the Sultanate of Oman. The descriptive approach was used, as well as a questionnaire of two parts to collect data. The questionnaire consists of (15) items divided into three themes about the relaxing level. It was applied on a sample of (406) male & female employees of the educational directorates who were randomly selected. The results of the study showed that the level of organizational relaxation was low. The study results also found that there were no statistically significant differences at the level of significance (α ≤ 0.05) of the study sample in the level of org
... Show MoreSoft clays are generally characterized by low shear strength, low permeability and high compressibility. An effective method to accelerate consolidation of such soils is to use vertical drains along with vacuum preloading to encourage radial flow of water. In this research numerical modeling of prefabricated vertical drains with vacuum pressure was done to investigate the effect of using vertical drains together with vacuum pressure on the degree of saturation of fully and saturated-unsaturated soft soils. Laboratory experiments were conducted by using a specially-designed large consolidometer cell where a central drain was installed and vacuum pressure was applied. All tests were conducted
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