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 study we have made a subject of fanny podcast in electronic media, as a new way to express different issues by the public, This study focuses started on how to address social issues in Alegria by ANAS TINA vidéo on the youtube network , you are to know the trends of young amateur about the various issues dealt with as well as the most important methods used to convince browsers.
The researcher used the survey method based on studying 10 episodes videos of blogger ANAS TINA.
The result of the study found that the most important issues are the abduction of children, teaching in Algeria; women in Algeria, The negative aspects of the issues addressed have been established in order to direct public opinion and awareness of ph
Abstract
This study talks about a wonderful Qur'anic style. relates to one of the methods used in it. And it's the rhetorical style: ''Affirmative say''. It is useful in arguing with the opponent, nullifying his reasoning, and proving the opposite meaning of the opponent. The study will be conducted from a Qur'anic perspective based on the study of examples of it, and partly in interpretive treatment through the book of editing and enlightenment of Taher Ibn Ashour, known for his art in matters of rhetoric and methods of controversy. This is with the rooting of this issue, and the relationship of industrial sciences to it as a Qur'anic style.
Keywords: ''Affirmative say, style, Qur'anic rhetoric, Arabic rhetoric, Co
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Post-structural critical studies highlighted the importance of studying the texts surrounding the text as an important part in the process of receiving and understanding texts, and although this topic was dealt with by the ancient Arabs and Europeans, interest in it appeared clearly after the appearance of Gerard Genet's book (SEUILS), which separated it Text Thresholds. Or what he called paratexte, and dealt with them with interest as he reads them on books. With the development of semiotic studies, interest in paratexte studies began in a broader way and in various literary and non-literary texts, including journalistic texts. And since specialized magazines are one of the press releases that enjoy their privacy in terms of topics and
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Tumor necrosis factor-alpha (TNF-α) antagonists’ therapy are expensive and has a non-responsive rate between 30% to 40% in rheumatoid arthritis patients. Genetic variation plays a vital role in the responsiveness to this type of therapy.The aim of this study is to investigate if the presence of genetic polymorphism in the TNF-α gene promoter region at locations -376 G/A (rs1800750), -806 C/T (rs4248158), and -1031 T/C (rs1799964) affects rheumatoid arthritis patient's tendency to be a non-responder to etanercept.
Eighty RA patients on etanercept (ETN) for at least six months were recruited from the Rheumatology Unit at Baghdad Teaching Hospital. Based on The European League Against Rheumatism response (EULAR) criteria, patient
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the Objective of study is to measure the quality of medical service level, in the Iraq public hospitals ,presented by special words ,private hospitals, and compare between them, by knowing the level of recipients satisfaction of medical service for all dimensions of quality service, and then measuring satisfaction with the quality of medical service as a whole for both of them, which have been prepared in questionnaire form, included two main directions, first to determine the level of satisfaction when, recipients of medical service is not dimensions quality of service in accordance with the Scale Servqual by (Parasurman et .al 1988), consisting of five di
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Isthmus life and prepare for it
This srudy aimed to use a new concentration from l\!J3T (Nitroblue tetrazolium) which using NADH stain ( by used eight different concentrations from (0.2% to 0.06% ).
That stain is a mitochondrial and cytoplasmic histochemical stain which gi ves more infom1ation about the metabolic activity of muscle fiber, so it is valuable in determining the types of muscle fibers and good fiber differentiation type {T) and type (TT) fibers), by reducing NBT in the location of enzyme and gives a blue color in different degrees according to the types of muscle fibers, and we noticed that the concentration 0.1% from NBT gives a good result and di
... Show MoreThe research aimed at identifying the level of Acute stress disorder and orientation towards supplication among the wives of the martyrs and knowledge of the two levels according to the age groups, academic achievement and profession. Sample of (72) wife of a martyr, and the results of the research indicated that the wives of the martyrs have symptoms of distress disorder and have adherence to the supplication to alleviate that disorder, as well as the results indicated that there are statistical differences in distress disturbance according to the variable of age groups, the profession variable and the variable of enrollment The academic year. As for the measure of the trend towards supplication, there are no statistical dif
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