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 issue of dignity is one of the topics that do not pass as long as the earths and the heavens remain; Because the earth is not devoid of the righteous, the believers, the saints, and the pious, and these do not cease from them aid, dignity, insight, or good vision, and from here the authorship in this section was continuous; Because the people’s need for it is confirmed as time progresses, and in that, Ibn Taymiyyah says in the sum of his fatwas, “And from what it should be known is that dignities may be according to the man’s need, so if the weak needs them Faith or the needy, he is given from it what strengthens his faith and fulfills his needs, and he who is more complete is the guardianship of God than him. He is independent
... Show MoreThe research is Concerned the Relationship between Self Management which is a modern administrative term and its dimensions "Self Control, Trust, and Conscientiousness" with the Hardiness and its dimensions "Challenge, Commitment, and Control". And the impact of the first variable on the second in The Hospital of Alshaheed Gaze Alharery.
The Questionnaire used and distributed on sample (60) Persons, contain from (40) Doctor, and (20) Employees from the total society (103).
The statistical methods have been used for testing the hypothesis is the mean, standard deviation correlation coefficient.
The resea
... Show More
A field study aimed at identifying the reality of the application of strategic management in the colleges of education/ University of Baghdad. The research adopted the descriptive analytical approach. The research community, consisting of 801 faculty teachers, has been identified. The research sample was selected in a simple random way and represented 15% of the research community, totalling 124 teaching members. A questionnaire was constructed that included (46) items divided between areas (strategic objectives, strategy planning and formulation, implementation of the strategy, and evaluation of the strategy). The honesty and consistency of the tool was verified. The researcher analyzed the research data using SPSS. The most important resu
... Show MoreThis research deals with the aesthetics of describing nature and the joys of urban life in the environment of Fatimid Egypt, among a group of poets, who were deceived by its enchanting beauty and breathtaking scenery, through it they depicted the reality of the life they live, and the things that involved them, as well as showing their personal culture, and the joys of life that experience, articulating this with a descriptive and analytical study, focusing on how the poet portrayed the visual scene, in an important stage of Arabic literature in Egypt.
The researcher aims to detect the emotive equanimity in kindergartens teachers,also to uncover the anxiousness in children of kindergartens,then to detect the relationship between them,then to choose the simple random way which is about(180) teachers and children,when the twore searchers made two tools to measure the emotive equanimity and the anxiety for both teachers and children,statistical methods had been used include:(pearsons correlation coefficient,t-test for one sample,t-test for two independent samples are individuals).the researcher led to multiple results:
1-the teacher has an emotive equanimity.
2-children has no anxiousness.
The research aims to find out the effect of Cognitive Acceleration strategy and random excitement strategy in achievement of geography material and developing the reflective thinking for students of literary fifth class .
the researcher depended a partial control experimental design with the three groups(the competence groups of the pre & post tests), The sample is deliberately selected from first AL-Rusafah Directorate General of Education in Baghdad. AL.fardoos Interme
... Show MoreThe first chapter the importance of research and need for education scientists see that the roots of the use of a specimen Wheatley in learning and teaching back to Grayson Wheatley, one of the largest supporters of a modern construction, which lay the groundwork for the specimen stage and the form in which it is. That was attributed to him, often called his name called while some educators based learning strategy on the issue. He sees the learner in this model make him a meaningful understanding of problems during his progress, thereby acting with his colleagues to find solutions to them in small groups. He
Borders Search: Search by students is determined by th
... Show MoreEducation is a process of learning and education at the same time. As the conditions of modern life necessitate every person to keep learning, education has become a necessity to meet life needs. The society today is concerned with the educational process and aims to live up the expectations. Since education is an integral part of education and its means, it has become as a mean to achieve its purposes. The educational environment was a traditional environment limited to specific inputs, possibilities and stimulus of both teacher and student. Due to the latest advancement, the educational environment has been expanded to become a rich, with strong connections. It has expanded to encompass the entire global environment. The current
... Show MoreAbstract A descriptive study was conducted in Al-Bashir teaching hospital in Amman city from 15th May 2004 to 15th August 2004 , in order to "Assess the adult asthmatic patients’ quality of life (QOL). Objective: This study aimed at identifying the domains of (Environmental, Physical, Daily Living Activity, Drug and Medication, Psychological , and Social), Methodology : A Purposive (Non-Probability) sample of (100) adult asthmatic patients visited the emergency department and outpatient clinic of chest department in Al-bashir hospital .A Questionnaire was constructed for the purpose of the study, and compris
Objectives: To identify quality of life (QOL) in Myocardial Infarction (MI) patients, and to find out the
relationship between QOL in MI patients and demographic characteristics.
Methodology: A descriptive colTelation study which utilized an assessment approach. The study was carried out
from March 2007 through November 2007 in order to assess the quality of life for patients with myocardial
infarction. A purposive "non-probability" sample of (75) patients with myocardial infarction who were attending
to Baquba General Hospita`l through their visits to that hospital. A questionnaire was adapted and developed
from the World Health Organization Quality of Life Scale (1998). The questionnaire was designed and
consisted