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.
In this study, nano TiO2 was prepared with titanium isopropoxide (TTIP) as a resource to titanium oxide. The catalyst was synthesized using phosphotungstic acid (PTA) and, stearyl trimethyl ammonium bromide (STAB) was used as the structure-directing material. Characterization of the product was done by the X-ray diffraction (XRD), X-ray fluorescent spectroscopy (XRF), nitrogen adsorption/desorption measurements, Atomic Force Microscope (AFM) and Fourier transform infrared (FTIR) spectra, were used to characterize the calcined TiO2 nanoparticles by STAB and PWA. The TiO2 nanomaterials were prepared in three crystalline forms (amorphous, anatase, anatase-rutile). The results showed that the
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Translation is a vital process that needs much more understanding and mutual background knowledge on the part of ESL or EFL learners in terms of grammar , meaning and context of both the SL and TL . Thus , the main aim of the current research paper is to identify and figure out the techniques used by ESL or EFL learners when translating English barnyard verbs into Arabic . The main problem of this study is attributed to the fact that ESL or EFL learners may not be able to identify and understand the connotative meaning of barnyard verbs since these verbs are onomatopoeic (i.e,) a word that phonetically imitates, or suggests the source of sound that it describes. Therefore they may be unable to translate these verbs appropriately and accura
... Show MorePraise be to God, Lord of the worlds, and peace and blessings be upon our master Muhammad, and upon his whole family and companions, but after: God Almighty has instituted types of acts of worship and classes of obedience that, if performed by the servant, would link him with his Creator and connect with his Lord. And for the sake of these worship, and the greatest of them: the worship of i'tikaaf, for souls need rest and recuperation from the struggle of life and its concerns, concerns and anguish, and people differ in their attitudes and interests in the means of recreation, and many people consider the outing and travel the best way in which they breathe from their toil and toil, and reclaim their strength and the advised adult He fin
... Show MoreABSTRACT
The aim of the research is to identify the impact of the areas of organizational change in strategic marketing planning in cement factories operating within the city of Al-Khums, and this effect was measured using a questionnaire consisting of 28 phrases, and it was relied on the descriptive approach that suits the nature of the subject of the research, while the research community consists of heads And members of the board of directors, authorized managers, unit managers and heads of departments in the factories under study, which numbered 55 respondents, during the month of September of the year 2021, and a sample of the compreh
... Show MoreThe emergence of the Internet and its transformation in the early nineties of the last century led to a means of mass communication that brought about significant structural changes in the media map.
Over the course of historical development, the public did not engage the media in its behavior in the implementation and dissemination of an idea, generalization or theory put forward by media experts or practitioners through these means to do it. Blogs represent the most important service provided by the Internet in recent years which has gained special importance in the media field. Where the word “Blogs” has several names: (alternative media), (blogging press), (popular press) and other names.
The medi
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ABSTRACT
The results showed that the organic fertilizer mixture (1:1) 30 tons/ha with chemical fertilization recorded the lowest level of bulk density of 1.2 g/cm3, the organic fertilizer mixture (1:1) 30 tons/ha with chemical fertilization recorded the highest percentage of aggregation stability amounting to 16.17%, the organic fertilizer palm fronds recorded the highest level of ready water with an average of 5.50 cm3/cm3 and the organic fertilizer mixture (1:1) 30 tons/ha without chemical fertilization recorded the highest level of ready water as it reached 6.93%, the or
... Show MoreUndoped and Iodine (I)–doped chrome oxide (Cr2O3)thin films have been prepared by chemical spray pyrolysis technique at substrate temperatures(773K) on glass substrate. Absorbance and transmittance spectra have been recorded as a function of wavelength in the range (340-800 nm) in order to study the optical properties such as reflectance, Energy gap of allowed direct transition, extinction coefficient refractive index, and dielectric constant in real and imagery parts all as a function of wavelength. It was found that all the investigated parameters affect by the doping ratios.
This research highlights one of the most important issues that have been controversial between Islamic schools, which is the duality of Intellect and Revelation and the nature of their relationship, in two core points:
The first point: Could there be a real conflict between Intellect and revelation? While the school of hadith view that this assumption is a rational assumption that does not real as long as the revelation is correct and the Intellect is clear, and that what is claimed are due to other Intellect s, we find that the Ash’ari school adopts the saying that the real conflict may occur, but rather confirms its occurrence.
The second point: For whom is the priority, for the Intellect or th
... Show MoreThe study attempts to measure the level of shyness; the level of psychological isolation; to identify the relationship between shyness and psychological isolation; and to identify the differences between shyness and psychological isolation among first-intermediate students. To this end, a random sample comprised (187) male and female students was chosen for the academic year (2016-2017) from Baghdad \ Al-Rasafa. To measure the shyness and psychological isolation, the researcher designed two scales: one to measure the shyness composed of (37) items divided into four domains; and the other to measure the psychological isolation made of (56) items divided into three domains. The study concluded that the sample has a medium level of shyness;
... Show MoreObjective: To assess the nurses-midwives' knowledge and practices regarding the management of second stage
of labor and to find out the association between their knowledge and practices and socio-demographic
characteristics and working years and experience.
Methodology: A descriptive study was carried out from March 22nd
, 2008 through 30th June, 2008. A purposive
sample of (75) Nurse-Midwives which was selected from (6) hospitals. A questionnaire was comprised of two
parts: (socio-demographic characteristics and the assessment tool for Nurse-Midwives' knowledge and health
practices performed by them). The questionnaire validity was determined by experts and its reliability was
determined through a pilot study. Th