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 investigate the skills of the intended meaning beyond the context when reading poetry among fifth literary students. To achieve the aim of the research, the researcher has followed the descriptive approach and used two tools: an open questionnaire that includes an inquiry about the skills of the intended meaning beyond the poetic context, and a closed questionnaire that were examined by the juries, and modified accordingly. Besides, its validity and stability were examined by applying the study on an exploratory sample of (15) teachers to reach its final version and determine the time required to answer it. Then, the researcher applied it on the research sample of (9
... Show Moreفقدان الزوج يعد حدثًا يغير حياة النساء، مما يضطرهن إلى السباحة في عالم جديد مليء بالحزن والوحدة والشكوك. مع الوقت، تطورت طريقة تصوير الأرامل بشكل كبير تعكس التغييرات في الآراء والقيم الثقافية. تُمثل الأرامل تقليديًا بأنهن ضعيفات ومعتمدات في الأدب، مستندة إلى افتراض أنهن يفتقدن الدعم المالي بعد وفاة شركائهن. ومع ذلك، فإن هذا التصوير لا يعترف بتأثير الأرملة على الرفاهية والهوية الشخصية. يسعى هذا النص إلى
... Show MoreElectric Quadrupole transitions are calculated for beryllium isotopes (9, 10, 12 and 14). Calculations with configuration mixing shell model usually under estimate the measured E2 transition strength. Although the consideration of a large basis no core shell model with 2ℏtruncations for 9,10,12 and14 where all major shells s, p, sd are used, fail to describe the measured reduced transition strength without normalizing the matrix elements with effective charges to compensate for the discarded space. Instead of using constant effective charges, excitations out of major shell space are taken into account through a microscopic theory which allows particle–hole excitations from the core and model space orbits to all higher orbits
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A new, simple and sensitive method was used forevaluation of propranolol withphosphotungstic acidto prove the efficiency, reliability and repeatability of the long distance chasing photometer (NAG-ADF-300-2) using continuous flow injection analysis. The method is based on reaction between propranolol and phosphotungstic acid in an aqueous medium to obtain a yellow precipitate. Optimum parameters was studied to increase the sensitivity for developed method. A linear range for calibration graph was 0.007-13 mmol/L for cell A and 5-15 mmol/L for cell B, and LOD 207.4792 ng/160 µL and 1.2449 µg/160 µL respectively to cell A and cell B with correlation coefficient (r) 0.9988 for cell A, 0.9996 for cell B, RSD% was lower than 1%, (n=8) for the
... Show MoreThe idea of this research is based on presenting a study specialized with the rules and bases of the Iraqi methodological music composition of the Symphony Orchestra according to the construction of the musical compositions of great forms and which are characterized by the melody difference and variation within their musical fabric according to the method of distributing the instruments and their types within the orchestra. The researcher has been interested in studying this building based on what is written for him according to the stringed instruments arc instruments and bass, which is represented by the cello and the contrabass. It is possible through the analysis of the melody structure features of these instruments and the melody re
... Show MoreThe study aims to identify the extent the academics in colleges of applied sciences are familiar with the themes of the national strategy of education 2040 in the Sultanate of Oman. The researchers used the descriptive approach, as well as they adopted a questionnaire with five dimensions as a tool for data collection, which was applied to (120) academics. The results showed that the academics of the applied colleges' familiarity with the National Strategy for Education 2040 in the Sultanate of Oman is average. The study also found that there were no statistically significant differences in the academics estimates of the extent of the Colleges of Applied Sciences academics’ familiarity with the themes of the National Education 2040 Str
... Show MoreQuality function deployment tool is trying to improve health services through this study that will be applied in health sector environment , and be based on applying quality function deployment tool (QFD) TO preferable evaluation of main patients requirements in order to determine the technical requirements that need most attention across improving and developing health services .
Main requirements are determined to patients lying in the hospital (under research) which is (educational Baghdad \ medicine city office) in Baghdad, and other technical requirements through pers
... Show MoreThe article is devoted to football lexicon in Arabic and Russian. The charr acteristics that determine the coincidence of lexical units in the Arabic and Russian languages are revealed. Football related words and phrases exist in different languages and in most cases they are the same. With the develop ment of football in the world and thanks to the media, new words and terms have become firmly established in the language. In Arabic, Italian and Span ish words are often used, but there are original Arabic phrases, most often consisting of two words - sports journalists and commentators actively use them. The word »mercato« was borrowed from the Italian language; in addi tion, in the Arabic language there is a phrase »Bab al-inti
... Show MoreIn many oil fields only the BHC logs (borehole compensated sonic tool) are available to provide interval transit time (Δtp), the reciprocal of compressional wave velocity VP.
To calculate the rock elastic or inelastic properties, to detect gas-bearing formations, the shear wave velocity VS is needed. Also VS is useful in fluid identification and matrix mineral identification.
Because of the lack of wells with shear wave velocity data, so many empirical models have been developed to predict the shear wave velocity from compressional wave velocity. Some are mathematical models others used the multiple regression method and neural network technique.
In this study a number of em
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