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 research is concerned with studying (the concept of freedom in the texts of Yaşar Kamal the play), as the Turkish playwright (Kamal Yasar) is one of the contemporary playwrights who have been interested in and criticize society, and perhaps the concept of freedom in his texts took a different form, through his ability to renew and present his attempts to create A theatrical form different from his earlier writers in dealing with the life of the peasants and the oppression that went through them, as the researcher identified the problem of his research with the following question: What is the concept of freedom in the texts of Yashar Kamal? The research aims to define the concept of freedom in the texts of Yashar Kamal of the play,
... Show MoreThis study aimed to identify the perceived mental image of volunteering, and its relationship to volunteer motivation among a sample of Al-Quds Open University students, as well as to identify the differences in the perceived mental image of volunteering due to variables (gender, year of study, place of residence, college). The researcher has used relational descriptive approach. The researcher has used two questionnaires, the first was used to measure the perceptive mental image of volunteering, and the second to measure the motivation towards volunteering, and the study population may consist of all students of Al-Quds Open University Hebron Branch during the first semester of the academic year 2021/2020 and their number (3462)Male and
... Show MoreThe modern business environment has witnesses tremendous developments as a result of the globalization of markets and economic openness and technological as well as the acquisition of the issue of corporate governance of great importance regarding it as one of the global innovations trends of control provisions on the management of companies as result of these developments ,increasing on competition between economic unit ,thus a decrease in market share because they do not take into account the response to the requirements of customers ,which kept her to search a modern management accounting methods to help them keep up with the changes and the availability of information for the various adminis
... Show MoreBackground: Langerhans' cell histiocytosis (LCH) is a group of conditions affecting the reticuloendothelial system. It includes Letterer-Siwe disease, Hand-Schuller-Christian disease and eosinophilic granuloma and most often presents in childhood. Materials and methods: Twenty-five cases of LCH were diagnosed histologically and confirmed by CD1a antibody and assessed immunohistochemically using anti-RANKL and anti-RANK antibodies to evaluate osteoclastogenic mechanism. Results: Regarding jaw cases, there was a significant correlation between CD1a and RANK (P=0.016). While in the skull, highly significant correlation existed between RANK and RANKL (p=0.001). Among the sites, there was no statistically significant difference found for each
... Show MoreThis research discusses the verbal follow phenomenon in Al-Amali Abi Al-Qali’s book (seq.356 Hijri). It aims to limit the examples of this phenomenon in the book, and examine it phonologically. Accordingly, the researcher adopted the analaytical descriptive approach, taking into account Al-Rawi’s letter when ordering the verbal follow-based examples, and the order they took in the book in question. The purposes behind this phonological study of verbal follow in Al-Amali’s book are to: reach the sounds which Arabs prefer in the process of following, confirm different beautiful and desirable senses, have easy and speedy pronunciation, maintain harmony between adjacent sounds, count the sounds that occur at the beginning of the
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Abstract
The Classical Normal Linear Regression Model Based on Several hypotheses, one of them is Heteroscedasticity as it is known that the wing of least squares method (OLS), under the existence of these two problems make the estimators, lose their desirable properties, in addition the statistical inference becomes unaccepted table. According that we put tow alternative, the first one is (Generalized Least Square) Which is denoted by (GLS), and the second alternative is to (Robust covariance matrix estimation) the estimated parameters method(OLS), and that the way (GLS) method neat and certified, if the capabilities (Efficient) and the statistical inference Thread on the basis of an acceptable
... Show MoreIn this study, a traumatic spinal cord injury (TSCI) classification system is proposed using a convolutional neural network (CNN) technique with automatically learned features from electromyography (EMG) signals for a non-human primate (NHP) model. A comparison between the proposed classification system and a classical classification method (k-nearest neighbors, kNN) is also presented. Developing such an NHP model with a suitable assessment tool (i.e., classifier) is a crucial step in detecting the effect of TSCI using EMG, which is expected to be essential in the evaluation of the efficacy of new TSCI treatments. Intramuscular EMG data were collected from an agonist/antagonist tail muscle pair for the pre- and post-spinal cord lesi
... Show MoreBackground: The aim of this study was to evaluate the shear bond strength (SBS) and adhesive remnant index (ARI) of different orthodontic adhesive systems after exposure to aging media (water storage and acid challenge). Materials and methods: Eighty human upper premolar teeth were extracted for orthodontic purposes and randomly divided into two groups (40 teeth each): the first group in which the bonded teeth were stored in distilled water for 30 days at 37°C, and the second group in which the bonded teeth were subjected to acid challenge. Each group was further subdivided into four subgroups (10 teeth each) according to the type of adhesive system that would be bonded to metal brackets: either non-fluoride releasing adhesive (NFRA),
... Show MorePolycystic ovary syndrome (PCOS) is a prevalent condition in women of reproductive age. It is characterized by androgen excess and chronic anovulation. Some trace elements, macroelements, and heavy metals have been linked to pathophysiological mechanisms of PCOS .
To study the alterations in the serum levels of the trace element manganese (Mn), some macroelements, magnesium(Mg) and calcium (Ca), and the heavy metals cadmium (Cd) and lead (Pb), in obese and non-obese PCOS patients; and the association of these alterations with some of the hormonal changes occurring in PCOS.
The study was carried out at Kamal Al-Samarrai Hospital (Center for Infertility treatment and in vitro Fertilization "IVF") Baghdad- Iraq. Eig
... Show MoreThe present study addressed "Performance Appraisal of Human Resource Management and Its Effect on Achieving the Organizational Success", for the topics of performance appraisal of human resource management and the organizational success gained an increasing interest being relatively important and modern topics which had a great effect on the future of organizations.
The study aimed at revealing the pattern of appraising the performance of human resource management for the study sample, and whether it was qualified to lead the ministry towards the organizational success, for this purpose two main hypotheses were formulated: 1) there is a positive significant correlation between both variables: performanc
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