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 find out the impact of Lee’s cognitive strategy on the achievement of fifth-grade literary students in the module of history. The research community consists of the secondary female day schools of Al-Karkh Al-Oula Directorate General of Education. The size of the research sample comprises (45) female students of the fifth grade of the literary brunch, (21) students for the experimental group and (24) students for the control group. The researchers have chosen an experimental design with partial control to suit the current research and its goal. They used a unified tool to measure the achievement of female students, which consisted of (50) items characterized by sincerity and they extracted the stability of t
... Show MoreIn this study, we review the ARIMA (p, d, q), the EWMA and the DLM (dynamic linear moodelling) procedures in brief in order to accomdate the ac(autocorrelation) structure of data .We consider the recursive estimation and prediction algorithms based on Bayes and KF (Kalman filtering) techniques for correlated observations.We investigate the effect on the MSE of these procedures and compare them using generated data.
The study aimed at ideutifying the impact of scieutific skills in strategy and liabits of mind amony stueuts in tenth grade . The study demanded to choose a sampie that coutaiun (42) student of the fourth grade of the secondary school who were dirided into tow groups , the first is experimental studied according to scieutific skill strategy , and the other controlling , studied according to the usualway . An achievement test has been taken that adopted staudard for mind skills as research tools that are applid after ascertaining sincerity proved at the end of the experiment .The study has reached to the conclusion that there are statistically significant differnces in farour of the experiment group in both
... Show Moreimportumt educational institution as (kindergartens) need teachers which qualified ownes modalities in their education for children , as Marzanu method in a way of learning and own methods of crisis management, because the teachers that own those styles of learning ginekindergarten children knowledge and the childrenIeaving based on theMeaing and knowledge and integration of their information, And teachers that earn methods of crisis management provide for the children of the kindergarten security within the educational institution which in turn affect the growth and development of the Child and then abilities, health physical, mental, psychological …etc.., The aims of the current research have identified to recognize: 1- the dimension
... Show MoreThe research aimed to diagnose and interpretation of impact nature between Communities of practice dimensions (participation and spreading knowledge, confidence, social capital build) deportation strategic change choices (reengineering business process, business re-structuring, business innovation) in construction companies in the Iraqi Ministry of Construction and Housing, the research tested 4 construction companies working in investing sector in Iraq, the research applied on a sample of 102 persons who participated in Communities of practice distributed in several administrative levels (directors, division directors, project directors and engineers) the research used questionnaire as a main tool for dat
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In this paper, the delay integral equations in population growth will be described,discussed , studied and transfered this model to integro-differential equation. At last,we will solve this problem by using variational approach.
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The research (Relationship of Communities of practice in adoption of, Strategic Change choices) aims to diagnose and interpretation of correlation nature between Communities of practice deportation (participation and spreading knowledge, confidence, social capital build) deportation strategic change choices (reengineering business process, business re-structuring, business innovation) in construction companies in the Iraqi Ministry of Construction and Housing, the research tested 4 construction companies working in investing sector in Iraq, the research applied on a sample of 102 persons who participated in Communities of practice distributed in several administrative levels (directors, division directors, projec
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With the study of synthesizing new organic compounds and exploring biological potency. Aryldiazenyl derivatives (2-5) were carried out by coupling of diazonium salt of 4-aminoacetophenone (1) and miscellaneous active methylene compounds such as: acetylacetone, ethyl cyanoacetate, dimedone or methyl acetoacetate. Moreover substituted 1,2,3-triazole (7-9) were synthesized by the cyclization of 1-(4-azidophenyl) ethanone (6); (which was obtained by coupling of diazonium salt (1) with sodium azid); with acetylacetone, methyl acetoacetate or methyl cyanoacetate, respectively. The structures of the prepared compounds were promoted by IR, H1NMR and UV/Visible spectra. Further, they were examined in vetro for antibacterial activity against five str
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The aim of the research is to identify the cognitive curiosity of students of religious schools in the al-Anbar Governorate. The sample consisted of (346) students from the secondary stage in religious schools affiliated with the Department of Religious Education and Islamic Studies. The sample included (232) males, (114) females, and (225) represented the intermediate stage, (121) represented the preparatory stage in religious schools. The researcher developed a scale of perceptual curiosity comprising (30) items with three alternatives (always applicable to me, rarely applicable to me, not applicable to me). The results showed that religious school students have a perceptive curiosity; there are no sta
... Show MoreThe contemporary ideas were characterized by the abundance and diversity of their knowledge, human and conceptual production, the strategy is both a general and a detailed framework covering all design disciplines both inside and outside the field of architecture. From here, many of these terraces emerged from fields outside the field of architecture, but soon moved to form an important nerve within the field of architecture. Hence the need to define a more comprehensive framework for studying one of the concepts that can frame the framework, namely the concept of "Alliteration", and its adoption as an architectural design strategy aimed at giving the resulting form a feature of rhetoric. So the research highlighted the
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