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 selective information broadcasting service is one of the important services in libraries and information centers, as it is the link between the source and the beneficiary and between related sources, as it links similar sources through keywords and then sends them to beneficiaries, which contributes to reducing the time and effort spent by beneficiaries in obtaining sources or information. Therefore, the application of this service is an important matter and gives a positive indicator in the progress of the library towards the integration of its services. From this standpoint, this research came to answer some questions, including: 1. What are the outlets for beneficiaries (the research community) in obtaining information sources? 2. Wh
... Show MoreThe importance of this research has been to rationalize the cost of producing maize seeds through the followers of modern techniques and methods in agricultural activities such as genetic engineering for the purpose of increasing production efficiency of maize seeds as well as the importance of calculating seed cost rationalization through the ABC system and thus rationalizing government spending. The research is based on a single hypothesis that the use of genetic engineering on corn seeds works to:increase production efficiency of seeds and savings in agricultural inputs, calculation of rationalization through the cost system on the basis of activity ABC The research reached a number of conclus
... Show MoreTo achieve the goals, the researcher followed the design of equal and independent groups of partial control and post-test . The research has chosen the Institute of Fine Arts in the area Almansour area as deliberate sample where three sections of students have been chosen and the number of students is (69) students. The researcher conducted equivalence in the variables (age, and IQ , and the overall rate for grade III). in diagnostic phase, (21) concepts of alternative image out of (46) concepts have been identified in addition to the goals of formulation of acquisition concepts according to the three processes (definition, discrimination and application). Achievement test has been
... Show MoreTheatrical performances began with the Greeks when the theatrical scenes and skeletal figures were encoded, where the large wall of the Alskina, which contains three doors, the middle of them with a high height, and the two sides took the natural size, where the middle door indicated a symbolism of the god or demigods, as we find the condensation of the symbol in the architecture of the theater, and the symbol was taken In the theatrical scene, the development semantically and aesthetically, and interpreting and interpreting the current day, where the laser light formed the symbolism of the contemporary virtual scene, and in order to identify the aesthetics of the symbol in the theatrical scene, the current research was evaluated into fo
... Show MoreThe goal of this research to identify the effect of the probing questions in the collection of material literature with students of the Kurdish language department, to achieve the aim of the research, the researcher has chosen a sample from the students of third stage of the Kurdish language Department, Faculty of Education / Ibn Rushd as a field for the application of experiment.The number of sample reached (71) students divided into two groups represented two divisions of the experimental groups under study to the style of questions sounding by (35) students, and represented the other division of the control group, which studied in the way normal and by (36) students, as rewarded r
... Show MorePrediction of penetration rate (ROP) is important process in optimization of drilling due to its crucial role in lowering drilling operation costs. This process has complex nature due to too many interrelated factors that affected the rate of penetration, which make difficult predicting process. This paper shows a new technique of rate of penetration prediction by using artificial neural network technique. A three layers model composed of two hidden layers and output layer has built by using drilling parameters data extracted from mud logging and wire line log for Alhalfaya oil field. These drilling parameters includes mechanical (WOB, RPM), hydraulic (HIS), and travel transit time (DT). Five data set represented five formations gathered
... Show MoreThe process of name calling in the propaganda discourse is one of the most important methods of persuasive propaganda act, based on the ideology of working with the function, and the valuation of this function, creating a hermeneutic representation of the meaning falls within a specific format and responds to a specific function, which is the realization of the intent of the propaganda doer in persuasion and persuasion through negative and positive propaganda logic. The method of name calling has played a dangerous and horrific role in conflicts and ideological and military wars throughout history.
This study aims to find out the mechanisms of semiotics system behind discourse of propaganda far from substantive&n
... Show MoreActing on the Holy Qur’an by contemplating its meanings, stopping at its commands and prohibitions, and everything in it that guides us to truth and mercy. The Holy Qur’an includes it for various purposes in one verse, and there is no doubt that this is part of the perfection of this great book, and one of the sciences of the fundamentalists is the indication of the context, and it is a great science of high rank, and it is one of the most important things that lead to the correct understanding of the miraculous and decisive book of God Almighty, and one of the best meanings of the Qur’an It was not from the context of the verses, and from here it can be said that the indication of the context is one of the origins of deriving lega
... Show MoreThe issue of peace, renunciation of violence, and acceptance of the other is one of the vital issues that rose to the top of the list of priorities at the end of the last century and the beginning of the new millennium of the conscience of the Iraqi people by spreading the culture of peace. In this context, we seek during this research to identify the concept of the culture of peace and its impact on sustainable development, and to draw a set of results and suggestions to consolidate this culture in our Iraqi society as an obligation of sustainable development.
New complexes of the type [ML2(H2O)2] ,[FeL2(H2O)Cl] and [VOL2] were M=Co(II),Ni(II) and Cu(II) ,L=4-(2-methyl-4-oxoquinazoline-3(4H)-yl) benzoic acid were synthesized and characterized by element analysis, magnetic susceptibility ,molar conductance ,FT-IR and UV-visible. The studies indicate that the L acts as doubly monodentate bridge for metal ions and form mononuclear complexes. The complexes are found to be octahedral except V(IV) complex is square pyrimde shape . The structural geometries of compounds were also suggested in gas phase by theoretical treatments, using Hyper chem-6 program for the molecular mechanics and semi-empirical calculations, addition heat of formation(?Hf ?) and binding energy (?Eb)for the free ligan
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