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 paper the oscillation criterion was investigated for all solutions of the third-order half linear neutral differential equations. Some necessary and sufficient conditions are established for every solution of (a(t)[(x(t)±p(t)x(?(t) ) )^'' ]^? )^'+q(t) x^? (?(t) )=0, t?t_0, to be oscillatory. Examples are given to illustrate our main results.
The study aims at finding out the effect of the lead time strategy on the first intermediate class pupils' achievement in geography The partial experimental design of two groups, experimental and control, with pre-post tests is used. The sample is represented in (73) female pupils. The sample is divided into two groups (37) experimental group and (36) control one. The sam ple is selected from first intermediate class pupils ( Al Batol intermediate school for girls) Baghdad Al-karkh-3, for academic year 2015-2016 The researcher has equalized the two groups in several variables: the previous achievement tests, intelligence, age in months, the scores of geography test of first course
The present study was designed to determine the predictive capacity of Coronavirus’s impact, as well as, the psychological adjustment among university students in Oman. A total of (566) male and female students were employed to form the swtudy sample. The descriptive method was used. The findings showed that there is a significantly university student affected by Coronavirus; the dimensions of scale were arranged as follows: the Academic requirements of pandemic came first, the social communication came second, and the academic future stress came in third. The results also showed that Psychological Adjustment among University Students was affected by the Coronavirus pandemic, the average was low. Also, the result showed that the Corona
... Show MoreIn the present study, the removal of zinc from synthetic waste water using emulsion liquid membrane extraction technique was investigated. Synthetic surfactant solution is used as the emulsifying agent. Diphenylthiocarbazon (ditizone) was used as the extracting agent dissolved in carbon tetrachloride as the organic solvent and sulfuric acid is used as the stripping agent. The parameters that influence the extraction percentage of Zn+2 were studied. These are the ratio of volume of organic solvent to volume of aqueous feed (0.5-4), ratio of volume of surfactant solution to volume of aqueous feed (0.2-1.6), pH of the aqueous feed solution (5-10), mixing intensity (100-1000) rpm, concentration of extracting agent (20-400) ppm, surfactant co
... Show MoreThe researcher focused on the importance of the physical abilities of the tennis game, as this game is one of the games that are characterized by its specificity in performance as this game is characterized by continuous movement and dealing with different elements, so this game requires the development of muscle strength, which plays an important role in Performance skills in the game of tennis. There are several methods to develop strength, including flat hierarchical technique, which is one of the most common forms of training in the development of muscle strength. As for the research problem, the researcher found a method that has an effect on the development of force. Therefore, the researcher tried to diversify a
... Show MoreThe research aims to identify the concept of green taxes and their role in reducing environmental pollution through the poll of Abnh of taxpayers and employees of the General Authority for taxes totaling 200 individual .autam adoption of the resolution as a tool head for the collection of data and information from the sample and analyzed their responses using a statistical program (spss - 10), and calculating the percentages and the arithmetic mean, standard deviation and research found to a number of conclusions, notably the lack of legislation with the challenges and the difficulty of the existence of a measure or a standard lack of planning for the application of environmental taxes that the state taxation application between the Gene
... Show Morethe history of the Scouting movement reflects the global social cultural and technological change over more than a century. scouting aims to develop young people worldwide through educational programs based on specific principles and values. in arab countries, the scouting movement is considered one of the most important platforms contributing to developing young people and enhancing their rule. positive in society, began with the establishment of the first Scout camp in the region and witnessed great growth and prosperity over the decades the research reveals the historical roots and development of the scout movement in the leading arab countries and analyzes the positive impact of scout movement in the leading arab countries on the develo
... Show MoreThe varied thermal conductivity (insulation) of silica aerogel with heating for different pH has been investigated, it has been depended on ambient pressure drying method in the preparing silica aerogel samples, also six different pH of samples (1, 2, 3, 7, 8 and 9) were treated under five degree of heating with (50,100,150,200 and 250) ᴼC. This technique is important to test the carry-outs hydrophobic silica to temperature without high-quality material changes in the basic characteristics. The hot-wire technique is used in this work to examine the thermal conductivity, Fourier Transform Infrared Spectroscopy (FTIR) depended to characterize the bonds and their artificial by heating. Resu
... Show MoreThe research aims to measure the extent of the impact of Earnings quality in the continuity of the company for a sample of private commercial banks listed on the Iraq Stock Exchange. The research sample included (15) of the listed commercial banks that continue to issue their financial statements for the period from (2009-2018).The research relied on three main models of measurement and on four steps. The first step is to measure the Persistence (Earnings Quality) by Depending the sustainability model. While the second step included measuring the Predictability of accounting profits by deriving the square root of the disparity of the estimation error from the first model Persistence (Earnings Quality), and the third step included
... Show MoreInvestment in high education is considered to be most important factors of production which the return an individual and social than economic returns found by searching the growing problem of unemployment, especially among youth graduates, where the unemployment rate in 2010 (50%) of these high rates have led to increased migration of scientific minds graduate recently, "to search for job opportunities outside Iraq for not hiring functions and this is in vain" clear "in the human and financial resources lead to structural imbalances in the Iraqi economy. When calculating the correlation coefficient between the graduates and the unemployment rate where it reached (0.21) emerged from the results of
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