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 research aims to diagnose the causes of the phenomenon of Marketing deception catalog, which is now deployed in the Iraqi market and related to producers and marketers, consumers, regulators and other institutions) and their impact in the areas of prejudice to the consumer protection (product and signifying specifications, price, advertising, packaging), as well as identify differences in the sample responses according to personal variables, it has been the adoption of the resolution as a tool to collect data and information through a sample survey of consumer opinions totaling 108 people in shopping centers in the province of Baghdad and in the Karkh and Rusafa, It was the use of methods selected statistical represented by the arith
... Show MoreThe purpose of this research is to highlight the relationship between the administrative investigation and the improvement of institutional performance, and the research sought to achieve a set of cognitive and applied goals. the administrative investigation is the modern trend of managing the offices of the general hginspectors and the main source to build the necessary standards to manage and invest its resources efficiently and effectively required to achieve the goals it seeks. The institutional performance is the cornerstone for the implementation of all tasks and duties carried out by institutions operating within the borders of a particular country, The significant change
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Vocational stresses and their relation with the level of ambition among the lecturers of the university In general , vocational stresses affect the attention and the process of focusing making individual busy with solving of his daily problems instead of his job. The vocational stresses , anxiety and tension are factors effecting the physical and psychological ability of the individual. This study aims to measure the vocational stresses among the lecturers of the university , to measure the level of ambition among them, to identify the statistical differences significant among them according to sex variable, to identify the differences significant in level of ambition among them according to sex variable and to identify the correlation r
... Show MoreWhat distinguishes human rights issues is their importance to the international community and their importance to democratic political regimes, because they are the axis of any political regime that seeks to achieve a successful democratic path and a stable state. So, countries that are interested in human rights try to enshrine those rights and freedoms in their constitutions and reinforce their concepts in their laws and legislations. Not to mention its involvement in international conventions and treaties concerned with human rights and freedoms, and this is what the Sultanate of Oman has worked on and confirm in the provisions of its 1996 constitution and its amendments
Christianity has rites and rituals that they should perform, and are indispensible. They say that these are sacred ordinances by Jesus Christ (PBUH) including the secret of priesthood. The origin of this secret as they claim is Christ. He puts the foundation of priesthood in Christianity. He has chosen twelve disciples and then seventeen whom he ordinated to obtain the honor of spreading the message of Christ among people. He appointed among the priests a divine message which the first fathers from the disciplesthemselves. The disciples are ones who take the secret and deliver it to the ones after them. The disciples took that sacred secret from Christ. Therefore, the secret is used when granting any religious position in the church. That s
... Show MoreThe purpose of this study is to assess the level of computer literacy of the students at AlQuds open university in Tulkarm Branch. The study investigates the effects of the variables of gender, specialization, academic level, owning a personal computer, internet communication, and own an email account on the level of computer literacy. A test of computer literacy was constructed by the researchers consisting of (37) multiple choice items with a reliability rate (0.85). The study population consisted of (4100) students, while the sample contained (352) students. The study revealed that the level of computer literacy of the students at AlQuds Open University in Tulkarm Branch was (66.2 %) which is educationally acceptable. It also
... Show MoreAbstract:
Inclusive education has experienced a number of positive educational trends and developments in many different countries, typically by recognising that all students, including those who have special educational needs (SEN), have a right to education. Inclusion of children with SEN in mainstream schools, alongside their peers, has become a major concern for interested educators, professionals and parents in many countries around the world. The reasons for this trend are due to a number of factors such as the increasing attention to the role of education in achieving social justice for pupils with SEN; the right of individuals with SEN to be educated along with their typically developing peers in mainstr
... Show MoreIn this research want to make analysis for some indicators and it's classifications that related with the teaching process and the scientific level for graduate studies in the university by using analysis of variance for ranked data for repeated measurements instead of the ordinary analysis of variance . We reach many conclusions for the
important classifications for each indicator that has affected on the teaching process. &nb
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Objective(s): To assess the types of violence among adolescents in Baghdad City.
A descripƟve study which was using the assessment approach was conducted on purposive sample of 60 parents of
adolescent for identify types of adolescents violence in their families, was selected according to specific criteria for
participating in health education program towards adolescents' violence control in Baghdad city.
Methodology: A questionnaire was constructed for the purpose of the study. It was consisted of two parts; the first
part which included the parents' demographic characteristics for parents (sex, age, educational level and socioeconomic
status); the second part included types of adolescent violence that reported by par
The phenyl hydrazine was react readily with acetic acid chloride in [1:2] ratio in alkyl of ethanolic solution, and refluxe for five hours to produce a new ligand of (N-Carboxymethyl-N-phenyl-hydrazino)-acetic acid [H2L].
(1)