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 statement to the amount of the contribution of information and communication technology in the quality of tourism and hotel services, and determine the relationship between the impact of information and communication and the quality of tourism services technology, The importance of the research is to establish the philosophical thinking of the nature of variables, as a modern administrative terminology and employ them towards the quality of tourism and hotel services, the research dealt with a problem expressed by a number of intellectual and practical questions, Was formulated based on the current situation witnessed by the tourism sector and hotel in Iraq, and the real gap was the lack of awareness of the impo
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Research Summary The aim of the search for knowledge of the effect generative learning strategy in: 1 - Achievement of the second grade. 2 - Systemic thinking for the second grade students when studying the biology. The study sample increased (60) students distributed into two equal experimental and control groups. Prepare the test of 40 pieces of multiple choice type and prepare a test for systematic thinking according to three skills 1. Understand the relationships between the parts of the systemic form and complement the sentences given 2 - complement the relationships between parts of the systemic form 3. Building the systemic form. It was a search result 1- There is a difference of statistical significance (at level 0.05) between th
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The aim of the research is to demonstrate the impact of the salary localization service in enhancing banking competitive advantage. In order to achieve this goal, salary localization was chosen as an independent variable and its impact was studied on the dependent variable, which is the competitive advantage. The research problem lies in the fluctuation of the salary localization service from one bank to another and the impact of this on the competitive advantage. The study sample included five private Iraqi banks, namely (the National Bank of Iraq, the International Development Bank, Assyria International Bank, Al Khaleej Commercial Ban
... Show MoreThe research seeks to design a program of guidance in the form of emotional perception rational to reduce the fear of failure, to identify the effect of method of emotional perception rational in reducing the fear of failure. To achieve these objectives, the researcher adopted the null-hypotheses, which assume there are no statistically significant differences in the degree of fear of failure (for the control group) in the pre-posttest. There are no statistically significant differences in the fear of failure (for the experimental group) in the pre-posttest. There were no statistically significant differences in the fear of failure of the groups (experimental and control) after the application of the program in the post-test. In order to
... Show MoreThe current research aims to identify the " impact of strategic warheads numbered ( NHT) in the collection average second grade students in the article of history). " To achieve this, I assumed the researcher that there is no different between the statistically significant the average score for the collection of experimental group who teaches the Arab Islamic history on and a strategic warheads numbered and the average score for the collection of the control group who were studying the same article according to the classic method ( traditional) . The study sample consisted of 64 students from the second grade average in the secondary warka bin nawfal in the general Directorate for education first karkh in Baghdad for the annual cources 2
... Show MoreThe current research aims to identify the impact of the amputated story style in the collection of sixth graders in elementary in the written expression subject.
The researcher, intentionally, chose Al-Ameen primary hybrid school which belongs to the directorate of education in Baghdad / Karkh first. The number of people of the sixth grade three classes. The researcher chose the two classes randomly to represent one of the experimental group, the number (32) pupils (male and female) have studied the expression subject by the amputated story style. Other control group, the number (32) pupils studied according to the traditional method.
The researcher prepared the lesson plans and presented to the experts, the researc
... Show MoreObjectives: The study aims to identify the quality of life level in schizophrenic patients and to find out the
relationships between the quality of life and some of personal characteristics for those patients with
schizophrenia.
Methodology: A descriptive correlation analytic design was used by using the assessment technique on sample
of 100 schizophrenic outpatients, who were selected purposively (non-probability sample) during the period
10/ 3/2013 - 1/ 12 /2013. The study was conducted on the schizophrenic patients in an out patient psychiatric
clinics at Ibn-Rushd; and Al-Rashad Psychiatric Teaching Hospital; Baghdad Teaching Hospital, and Al-Kadhimya
Teaching Hospital. Self administrative questionnaire was used
A mathematical model has been introduced to investigate the effect of nuclear reaction constant ( A ), probability of the BEC ground state occupation Ω i, nD is the number density of deuteron (d) and the overall number of nuclei ND on the total nuclear d-d fusion rate (R). Under steady-state of the condensates of Bose-Einstein, the postulate of quantum theory and Bose-Einstein theory were applied to evaluate the total nuclear (d-d) fusion rate trapping in Nickel-metal The total nuclear fusion rate trapping predicts a strong relationship between astrophysical S-factor and masses of Nickel. The reaction rate trapping model was tested on three reaction d(d,p)T, d(d, n)3He and d(d, 4He)Q = 23.8MeV respectively. The reaction rate has described
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Education is the most powerful and important weapon in fighting poverty and unemployment because it provides students with new skills that appropriate the new market requirements and fair distribution of natural resources. It also transfers knowledge, skills, and ethics over generations. Education aims to create effective leaders who go under training and rehabilitation process, create a new human and instill faith, generate the creativity and innovation, and keep abreast with scientific process, updating curriculum, and finally, applying the technical education
The research dealt with the concepts of the philosophy of values and its epistemological variables according to specific propositions represented in their scientific approaches to value theory in the field of industrial design. As the epistemological propositions of the theory of values were dealt with based on the epistemological fields that dealt with the concept and what values are, starting with the modernist propositions and postmodern, passing through the propositions of sociological and psychological thought, which was a prelude to extracting the concepts of value theory and adopting it in the field of industrial product design. The epistemological approaches to value theory in industrial product design were repr
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