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.
Whereas conventional methods of teaching history do not meet the sometimes purpose has suggested some educators strategies modern help to improve the level of students in the education process through activating prior knowledge and employed in positions of current learning, and focus attention on the points and the outstanding elements of the content and practice techniques Calendar criticof ideas and meanings and mental and linguistic activities used to verify the extent of reaching understanding. &n
... Show MoreThe research dealt with the effect of the tax examiner's efficiency in detecting tax evasion, as the research problem dealt with tax evasion, especially in Iraq, for many reasons and factors, including those related to tax administration represented in administrative corruption and the complexity of procedures in the tax accounting process and failure to achieve justice in the tax treatment, including the taxpayer himself, as he tries to evade for reasons Related to the level of tax awareness, loss of confidence in the tax administration, and reasons related to the state's inability to manage the services file well and its ability to achieve the set goals, This reflected negatively on the emergence of some of the consequences of
... Show MoreThe article deals with the role of metaphors in forming the plot of L. Ulitskaya’s family chronicle “Medea and Her Children”. The author of the article describes the results of the next stage of research related to the works of Lyudmila Evgenievna Ulitskaya, a representative of modern Russian prose. The analysis of tropes and figures in the works written at the turn of the XXth – XXIth centuries is of importance for the study of the modern state of Russian language as an independent system. “Medea and Her Children” is one of the works by L. Ulitskaya (written in 1996), which, like her other works, is characterized by a unique style of narration, rich in vocabulary, lexical, semantic and stylistic diversity of the author’s word
... Show MoreAs they are the smallest functional parts of the muscle, motor units (MUs) are considered as the basic building blocks of the neuromuscular system. Monitoring MU recruitment, de-recruitment, and firing rate (by either invasive or surface techniques) leads to the understanding of motor control strategies and of their pathological alterations. EMG signal decomposition is the process of identification and classification of individual motor unit action potentials (MUAPs) in the interference pattern detected with either intramuscular or surface electrodes. Signal processing techniques were used in EMG signal decomposition to understand fundamental and physiological issues. Many techniques have been developed to decompose intramuscularly detec
... Show MoreAbstract:
The aim of this research is to highlight the importance of achieving customer satisfaction by using information technology and Internet networks in the process of purchasing flight tickets, and switching from the traditional method of purchasing and payment operations to the electronic method, to reduce the financial and non-financial risks associated with the traditional purchasing process, as well as saving time, effort and costs for the customer. The researcher used the deductive approach in linking the variables (achieving customer satisfaction and Internet of Things technology for booking electronic tickets)
... Show MoreThis research seeks to attempt to reveal the intention of Al-Hafiz Al-Mazi from his market to hadiths from Imam Ahmad’s Musnad in his book “Masterpiece of Supervision in Knowing the Parties”, and researchers know that this book was classified by Al-Mazi to collect the parties to the six books: Sahih Al-Bukhari, Sahih Muslim, Sunan Abi Dawud, Jamea Al-Tirmidhi and Sunan Al-Nasa’i and Sunan Ibn Majah, in addition to some of the books ’authors’ books, and arranging them according to the Musnad, and it is not Musnad Ahmad from his condition, even if it is close to the arrangement of Mazi’s work, as he was a follower of that to the original owner Abu al-Qasim bin Asaker in his book “Supervising Knowledge of the Parties” in M
... Show MoreThe purpose of this resesrh know (the effectiveness of cooperative lerarning implementation of floral material for calligraphy and ornamentation) To achieve the aim of the research scholar put the two zeros hypotheses: in light of the findings of the present research the researcher concluded a number of conclusions, including: -
1 - Sum strategy helps the learner to be positive in all the information and regulations, monitoring and evaluation during the learning process.
2 - This strategy helps the learner to use information and knowledge and their use in various educational positions, and to achieve better education to increase its ability to develop thinking skills and positive trends towards the article.
In light of this, the
Objective: Evaluation of women's knowledge about risk factors and early detection of breast cancer at
Ibn Rushd college of education in Baghdad University.
Methodology: The study sample included (184) women in the Ibn Rushd College / University of
Baghdad, whose age ranged between (17-58) years. Data were collected through a structured
questionnaire prepared by the National Cancer Research Center which were answered during a scientific
symposium about breast cancer. The score was calculated by correcting the results of the answer, giving
one score for each correct answer and then estimating the level of knowledge and inputting all data in a
statistical program.
Results: The results showed limited level of women's
The research aimed to study the role that the media play in shaping the public knowledge of human rights issues among the people of Kirkuk, which will be the focus of the study. The research was conducted by applying a survey panel to a random sample of the city's audience. The research dealt with the theoretical aspect of a theory that relied on the media, and the loans provided by the theory, on the basis of which the research was conducted and the research problem was determined based on a major question: What is the role that the mass media play in developing the knowledge of members of the public on human rights and the relationship between the intensity of view in that, as well as the identification of the effect of two variables G
... Show MoreThe marketing logistic chain, as an integrated system aimed to balance the achievement of its main opposite objectives which represented in the access to the best service presented to the customer with lowest possible logistic costs especially the transportation costs, where encourages the researcher to choose the second objective as a field of this study in order to reduce the transportation costs in the final link of marketing logistic chain which related to delivering of fuel oil to the customer that falls within organizational responsibilities of the company under consideration (Oil Marketing Company) and also known in a brief name by (SOMO) through two methods, the first is by functioning quantative techniques by using trans
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