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 main aim of this paper is to explain the effect of the aggregation accounting information on the financial, investment, and operational, managerial decision-making and the evaluation of the financial statements after aggregate. The problem of this study is represented in administrative decision-making that takes place under differentiated accounting systems operating within a governmental economic unit that seeks at the same time to achieve a unified vision and goals for the organization. This study was conducted at the College of Administration and Economics /University of Baghdad, and it represents a sample from a community of governmental economic units that apply differentiated accounting systems. The study method is repr
... Show MoreThe study aimed to reveal the level to which the international issues are integrated into the books of Saudi public education social studies and citizenship in the light of the principles of international education, and to know the level of continuity and integration of these issues in the books, to build a range and sequence matrix of international issues through it. The study followed the descriptive and analytical method that used the content analysis card as a tool for study when the tool achieved the necessary validity and reliability characteristics. The data of this study has been processed using the SPSS statistical program according to a set of appropriate methods of descriptive and inferential statistics.
The resu
... Show MoreThis study aims to explore the relationship between the degree of application of digital leadership and the development of administrative work at the University of Tabuk. It further aims to examine the presence of statistically significant differences between the average responses of faculty members and employees at the University of Tabuk regarding the study axes that are attributed to the following variables: (scientific rank, gender, and job), the study used the descriptive approach in its correlative style, and the questionnaire was used as a tool for data collection, as it was applied to a simple random of (310) members of the faculty and staff. University of Tabuk. The results showed that the degree of digital leadership applicatio
... Show MoreA statistical study was made to know the characteristics of Decametric (DAM) emission emitted from Jupiter's planet. These characteristics are the sporadic nature, time, type and the frequency. Period of 11 years was taken to study the first and year 2004 was taken to study the others. Data were provided from Radio Jove project, which gave information about the observer's location, date, time, type and the frequency. The results indicated that the DAM emission was sporadic, the time was between (00:01-05:31) hour, it was found that (Io-B) is the largest number, as compared with others , a large number emission occurred at frequency range (20-21) MHz. The results were compared with results of Radio Jove software, which indicated that the DAM
... Show MoreBackground: spontaneous abortion constitutes one of the most important adverse pregnancy outcomes affecting human reproduction, and its risk factors are not only affected by biological, demographic factors such as age, gravidity, and previous history of miscarriage,but also by individual women’s personal social characteristics, and by the larger social environment. Objective:To identifyEnvironmental effects on Women's with Spontaneous Abortion. Methodology:Non-probability(purposive sample)of(200) women, who were suffering from spontaneous abortion in maternity unitfrom four hospitals at Baghdad City which include Al-ElwiaMaternity Teaching Hospital, and Baghdad Teaching Hospital at Al-Russafa sector. Al–karckhMaternityHospita
... Show MoreFreedom of opinion and expression occupy the first place among the concerns of countries and international organizations. And it is also the basis of contemporary freedom because it is the foundation for achieving freedom in other fields such as politics, economics, education, etc.. The constitutions of the state have ensured that almost the entire freedom to express an opinion in all its forms either orally or writing or images of expressions, but these freedoms are identified within the law. Most countries announced their commitment to the international conventions and texts issued by international and regional organization like the Universal Declaration of Human Rights in 1948, and the International Covenant on Civil and Political Rig
... Show MoreThe principle in the language is that each word has one meaning. This is because the purpose of language development is for understanding, understanding, and communication between people. The language is sounds with which each people expresses their Arabic language did not stop at this point, but rather needed another next stage or to convey additional features or characteristics that would qualify it. To be the language of the Qur’an and revelation, and capable of carrying this heavy burden.
This paper deal with the estimation of the shape parameter (a) of Generalized Exponential (GE) distribution when the scale parameter (l) is known via preliminary test single stage shrinkage estimator (SSSE) when a prior knowledge (a0) a vailable about the shape parameter as initial value due past experiences as well as suitable region (R) for testing this prior knowledge.
The Expression for the Bias, Mean squared error [MSE] and Relative Efficiency [R.Eff(×)] for the proposed estimator are derived. Numerical results about beha
... Show MoreThe study aims to analyze computer textbooks content for preparatory stage according to the logical thinking. The researcher followed the descriptive analytical research approach (content analysis), and adopted an explicit idea during the analysis process. One of the content analysis tools which was designed based on mental processes employed during logical thinking has utilized to figure out the study results. The findings revealed that logical thinking skills formed (52%) in fourth preparatory textbook and (47%) in fifth preparatory textbook.