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 aim of this study is to achieve the best distinguishing function of the variables which have common characteristics to distinguish between the groups in order to identify the situation of the governorates that suffer from the problem of deprivation. This allows the parties concerned and the regulatory authorities to intervene to take corrective measures. The main indicators of the deprivation index included (education, health, infrastructure, housing, protection) were based on 2010 data available in the Central Bureau of Statistics
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Abstract:
Objective(s): The present study aims to evaluate the effectiveness of Health educational program on nurses' knowledge toward children pneumonia at Al-Amara City hospitals..
Methods: A quasi –experimental study design two-study group (pretest-posttest 1 and posttest 2) carried out at Alzahrawy Hospital and Child and maternity hospital in Al Amara City to identify the effectiveness of the Health educational program on Nurses Knowledge toward Children pneumonia; the study was conducted between 1 of September 2019 to 1 of April 2020. A Purposive (Non-probability) sample is chosen for the present study. The size of sample is (60) nur
... Show MoreThe internationalization of the Libyan crisis and its accompanying militarization of the conflict have played a vital role in hindering to reach a comprehensive political settlement solution in Libya. The increasing international greediness in the Libyan energy resources and the geopolitical importance of the Libyan State led to the involvement of many international and regional powers in this crisis and transformed the Libyan crisis into “proxy war”. Moreover, the Turkish direct military intervention in the Libyan crisis is considered as one of the main constraints facing the international and regional efforts to settle the Libyan crisis as a result of the Turkish insistence on its military existence in Libya to preserve i
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The ideas and principles formulated by Ibn-Jamaah in the field of education occupy a central place in the historical origins of education for Muslims. These views and principles have an active role in the educational reorganization that the Islamic world aspires to. These ideas have had a great impact on the educational process that had preceded the opinions of Russo, Pestalutzi, Fruel, Herbert, and Dewey. Moreover, we have seen that the Sheikh of Ibn-Jamaah has taken part in formulating the origins of education and leadership.
Objective(s): The present study aims to evaluate the effectiveness of Health educational program on nurses' knowledge toward children pneumonia at Al-Amara City hospitals..
Methodology: A quasi –experimental study design two-study group (pretest-posttest 1 and posttest 2) carried out at Alzahrawy Hospital and Child and maternity hospital in Al Amara City to identify the effectiveness of the Health educational program on Nurses Knowledge toward Children pneumonia; the study was conducted between 1 of September 2019 to 1 of April 2020. A Purposive (Non-probability) sample is chosen for the present study. The size of sample is (60) nurses divided into two gr
... Show MoreThe current research aims to evaluate the activities and evaluation questions implied in the content of the computer textbook for the fifth preparatory grade according to the creative thinking and developing suggestions through answering the following question: what is the percentage of creative thinking skills in the content of the computer textbook for the fifth Preparatory grade students issued by the Iraqi Ministry of Education/ Directorate General of the curriculum in the academic year (2019-2020)? The researchers followed the descriptive-analytical approach. The research community was determined by the content of the computer textbook for the fifth preparatory grade. As for the research sample, it was limited to all activitie
... Show MoreThere many methods for estimation of permeability. In this Paper, permeability has been estimated by two methods. The conventional and modified methods are used to calculate flow zone indicator (FZI). The hydraulic flow unit (HU) was identified by FZI technique. This technique is effective in predicting the permeability in un-cored intervals/wells. HU is related with FZI and rock quality index (RQI). All available cores from 7 wells (Su -4, Su -5, Su -7, Su -8, Su -9, Su -12, and Su -14) were used to be database for HU classification. The plot of probability cumulative of FZI is used. The plot of core-derived probability FZI for both modified and conventional method which indicates 4 Hu (A, B, C and D) for Nahr Umr forma
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ANN modeling is used here to predict missing monthly precipitation data in one station of the eight weather stations network in Sulaimani Governorate. Eight models were developed, one for each station as for prediction. The accuracy of prediction obtain is excellent with correlation coefficients between the predicted and the measured values of monthly precipitation ranged from (90% to 97.2%). The eight ANN models are found after many trials for each station and those with the highest correlation coefficient were selected. All the ANN models are found to have a hyperbolic tangent and identity activation functions for the hidden and output layers respectively, with learning rate of (0.4) and momentum term of (0.9), but with different data
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The biggest problem of structural materials for fusion reactor is the damage caused by the fusion product neutrons to the structural material. If this problem is overcomed, an important milestone will be left behind in fusion energy. One of the important problems of the structural material is that nuclei forming the structural material interacting with fusion neutrons are transmuted to stable or radioactive nuclei via (n, x) (x; alpha, proton, gamma etc.) reactions. In particular, the concentration of helium gas in the structural material increases through deuteron- tritium (D-T) and (n, α) reactions, and this increase significantly changes the microstructure and the properties of the structural materials. T
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