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 current research aims to know the effect of gardens ideas strategy on deductive thinking among fourth-grade science students in physics.
To investigate from the aim of the research, researchers put the following zero hypothesis:
- No statistically significant differences at the level of significance (0.05) between the students mean scores of the two groups on indicative thinking test.
The research was carried out on the scientific fourth grade male students in Al – Mansour in Baghdad; belong to Education Directorate Al- Karkh /1, for the Academic Year (2014-2015) A.D.
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... Show MoreThere is no doubt that Jane Austen is one of the most studied authors of the late 18th and early 19th centuries. Her female characters have been extensively studied and they seem to have aroused much interest as manifestations of the conduct of their time. Her heroines have realized that there were many mistakes in the rules of conduct that controlled and restricted their behaviors. Thus, they have found no fault in correcting these mistakes, by behaving naturally without acting. Elizabeth Bennet the heroine of Pride and Prejudice and Marianne Dashwood of Sense and Sensibility are the chosen examples of that kind of women.
In this paper, we consider the problem of stochastic project network when some or all activities are interrupted. An approach has been built to schedule the critical activities, by constructing some expressions based on the project lateness costs due to the interruption activities. Two simple example are presented to validate our approach.
Key words: Project Management, Project scheduling, Stochastic activity duration, Stochastic PERT.
Introduction
Recently, Projects planning and optimal timing, under uncertainty are extremely critical for many organizations, see [19]. Having an effective mathematical model wi
... Show MoreThe effect of 5555 strategy on reading comprehension among 4th preparatory students Assist. Prof. Dr. Hassan Khilbas Hammadi College of Education Ibn Rushd – The University of Baghdad Assistant Lecturer. Waleed Khaled Talib Directorate – General For Education Province Of AL - Anbar The purpose of study is to identify the effect of 5555 strategy on reading comprehension among 4th preparatory students. To do this, null hypothesis was postulated. The author hypothesize that there is no a statistically significant difference at (0.05) level between experimental group's scores who study reading comprehension subject following the 5555 strategy and control group's scores who study the same subject following the traditional method in readin
... Show MoreSince its inception, the theatrical performance has been based on the principle of permanence, continuity, renewal and innovation in the structure of its visual elements. These innovations and the effectiveness of continuity cannot be achieved without searching for everything that is new and different at the level (form and content) in order to create an image with innovative and effective features in the theatrical discourse, and from Among the elements of the theatrical performance (theatrical costumes) that have been subject to variation since the beginning of the theater until now, and for this purpose, the current research was conducted with the question of the research problem: What are the variations of costumes in the contemporar
... Show MoreThe use of different materials in the art of ceramics is considered a new form of contemporary philosophical trends. That was introduced to art as a result of societal changes and transformations and rapid technological development. And it plays a very essential part in the beauty of the artistic structure. The contrast of using different materials in ceramics is considered a part of the old historical achievements since the art of ceramics used to follow strict standards. Which does not apply to contemporary ceramic, Because recently, it has become free from any religious and social control and created a whole new intellectual context, heading to new horizons in which it works with the newly added materials as a strategy to ensure the a
... Show MoreThe trade war, of course, leads to a sharp tension in international relations because the economy is the lifeblood of the states. In the world of trade and economy, countries began to lean towards cooperation. Economic relations after World War II were more liberal, trade barriers were removed and global trade became more flexible and smooth
The modern teaching methods, and their importance in achieving the desired learning goals for the individual and the society, have been addressed, as it is necessary to develop the methods, ways and strategies used in the process of teaching the intermediate stages in the various fields in general and the field of physical education in particular, the importance of research is the effect of using the strategy of similarities in teaching some basic skills of basketball for students of the second intermediate. As for the problem of research, the researcher mentioned the lack of use of teachers’ strategy method similarities in the educational units because of its importance, and after study and analysis the researcher found it necessary to i
... Show MoreThe study included the extraction of volatile oil from Mentha piperita which was 1.3 % in the leaves and flowers . Volatile oil of the Mentha piperita leaves had special aromatic odour, pale yellow color, slightly pungent taste . The specific gravity and refractive index were (0.9794) and ( 1.464) respectively. The inhibition activity of the Mentha piperita Volatile oil extracts were studied on some pathogenic microorganisms like Staphylococcus aureus, Salmonella typhi, Escherichia coli, Proteus sp, and Klebsiella pneumoniae . The result showed that the volatile oil had an inhibition effect on the growth of all microorganisms, and it gave the higher inhibition effect on the growth of S. aureus in which the inhibition zone reached to 2
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The teacher is the most able to achieve the goals of education in education because he has the ability to affect the behavior of the disciples testified and its actions and appearance and other actions that convey pupils with it sometimes in a manner unconscious or unconscious , and the importance of the role of the teacher in the educational process , it is necessary to compromise the care and attention to the extent that commensurate with the important role that the rise in the preparation of youth and composition , and as a result is needed to continue efforts to improve the quality of teacher preparation so that it can be more effective and positive in the educational process .
First - Research Goals -<