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.
This work aimed to estimate the frequency of mitochondrial inborn errors of metabolism (MIEMs) in patients presenting with family history and IEM-picture who referred for advance IEM assay in Mosul province and Kurdistan region. This study was observational study conducted on 364 cases referred from different general /or private pediatric clinics with unexplained sign and symptoms and suspension of mitochondrial dysfunction. The study included 364 children with an age ranging from 1 month to 1 year. Started from January 2018 to January 2020. All patients referred with their full history review, notes about their clinical examination, and laboratory investigations including blood ammonia, serum lactate/ pyruvate, arterial blood gases. In
... Show MoreIn this paper, the construction of Hermite wavelets functions and their operational matrix of integration is presented. The Hermite wavelets method is applied to solve nth order Volterra integro diferential equations (VIDE) by expanding the unknown functions, as series in terms of Hermite wavelets with unknown coefficients. Finally, two examples are given
The dialogue considers a method and life curriculum help to solve many problems as well as the best way to build a healthy family setting supports the growth of children and leads to the formation sound, strong and positive character. It also supports the family relationship. many of family members needs may achieve through what prevails among them such as continuing a comprehensive and deep combines word, deed and feeling it enters the body and soul . So each part strengthens by the other part and exchanges effect The deep domestic dialogue opens hearts between parents and children Family increases more loving , intimacy , honesty and happiness. So the domestic dialogue became an urgent necessity in the light of many socia
... Show MoreBackground: Tumor associated tissue eosinophilia (TATE) has been described in a variety of neoplasms. In regard to squamous cell carcinoma, some studies worldwide done to assess stromal eosinophilia in oral and cervical squamous cell carcinoma. The objectives of this study is to evaluate the association of stromal eosinophilic infiltration of cutaneous squamous cell carcinoma and to detect the significance of this association. Aim of the study The aim of our study is to establish the relationship between the degree of stromal eosinophilia and the level of invasion and the histological grade in cutaneous squamous cell carcinoma. Methods: In this retrospective study done at the histopathology department of al Wasity teaching hospital for orth
... Show MoreThe research aims to investigate the existence of a direct causal relationship between selected agricultural variables: agricultural output (as a representative of growth in the agricultural sector), agricultural terms of trade as a completely new variable in agricultural studies in recent years, agricultural labour which is an important part in the total workforce for Iraq, and finally, agricultural investment because of its importance and vital role in the production process, creating job opportunities, and then raising the level of employment, then it's role to achieving agricultural growth and development. For this purpose, the researchers used the Toda-Yamamoto causality methodology for a time series covering from 1990 to 2019. The res
... Show Moreفي هذا العصر - الذي داهمت في الأخطار لغة الفصاحة والبيان - يبقى القرآن الكريم أعظم حافظ للغة السليمة ، وأكبر معين لأهلها للحفاظ على ثرائها وبلاغتها ، فهي باقية ببقائه ما بقي الليل والنهار .
وهذا البحث يدور حول حفظ القرآن الكريم وأثره على لغة الطفل، ويتكون من مقدمة : وفيها بيان أهمية الموضوع ، وخطة البحث ، ومنهجه، وثلاثة مباحث:
المبحث الأول : فضل حفظ القرآن الكريم ، وفوائد حفظه إجمالاً ، والمبحث الثاني :
... Show MoreThe objective of this study is to analyze the difficulties faced by intermediate-level Iraqi students in the use of Spanish unstressed pronouns as a foreign language (ELE). Through a mixed methodology, a descriptive and explanatory analysis was conducted based on written and oral productions of B1-level students at the University of Baghdad.The results show that factors such as interference from the native language (Arabic) and English, as well as grammatical differences between Spanish and Arabic, generate difficulties in the correct use of unstressed pronouns. A contrastive teaching approach is proposed that takes advantage of students' cognitive abilities to highlight similarities and differences between both languages.This stu
... Show MoreThis study investigated three aims for the extent of effectiveness of the two systems in educational development of educators. To achieve this, statistical analysis was performed between the two groups that consisted of (26) participants of the electronic teaching method and (38) participants who underwent teaching by the conventional electronic lecture. The results indicated the effectiveness of the “electronic teaching method” and the “electronic lecture method” for learning of the participants in educational development. Also, it indicated the level of equivalence from the aspect of effectiveness of the two methods and at a confidence level of (0.05). This study reached several conclusions, recommendations, and suggestio
... Show MoreAbstract:
The aim of this research is to highlight the importance of reducing the cost of a flight ticket by using information technology and the Internet, in the process of purchasing tickets for electronic flights, and to shift from the traditional method of purchasing and payment operations to the electronic method, to reduce the financial and non-financial risks associated with the traditional purchase process, as well as saving the cost Time, effort and money for the customer, and the researcher used the deductive approach in linking the variables (Internet of Things technology and reducing the costs of air tickets) wi
... Show MoreThis study aims to examine the sources of organizational power prevailing among the academic leaders at the University of Tabuk from the faculty members’ viewpoint. The purposes behind such an aim are: to reveal the level of administrative and technical institutional creativity, the nature of the relationship between the reality of organizational power and the level of institutional creativity, and to disclose statistically the significant differences between the averages of faculty members’ responses attributed to the demographic variables (gender, years of experience, academic degree). The study used the descriptive approach, both survey and correlational. A questionnaire was used to collect data from a simple random sample o
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