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 the research is to investigate potential effects of the finance industry and block-chain to general business of financing in particular, as well as its shortcomings and difficulties. To answer the research questions, the researcher used the objective narrative-analytical descriptive approach and included a qualitative analysis of Blockchain technology. The process of Blockchain technology based on their industries, the authors were selected based on their reputation in the Blockchain field. The research found that Blockchain can improve the efficiency of the banking industry's various sections. It has the ability to upgrade and transfer wages across borders, financial reporting and compliance, as well as trade finance
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This research aims to study the reflection of accounting for contingent assets and liabilities and provisions on Faithful Representation characteristic of accounting information, To achieve this goal has been questionnaire design has been distributed to research sample, which consists of (50) li
... Show MoreIn this research, the methods of Kernel estimator (nonparametric density estimator) were relied upon in estimating the two-response logistic regression, where the comparison was used between the method of Nadaraya-Watson and the method of Local Scoring algorithm, and optimal Smoothing parameter λ was estimated by the methods of Cross-validation and generalized Cross-validation, bandwidth optimal λ has a clear effect in the estimation process. It also has a key role in smoothing the curve as it approaches the real curve, and the goal of using the Kernel estimator is to modify the observations so that we can obtain estimators with characteristics close to the properties of real parameters, and based on medical data for patients with chro
... Show MoreJeder Lernende, der in der Fremdsprache Deutsch kommunizieren möchte, wird sich auch mit der deutschen Aussprache beschäftigen (müssen). Wer eine gute Aussprache hat, wird nicht nur oft und zu Recht bewundert, er hat es auch leichter, die deutsche Sprache zu verstehen, und er wird gut verstanden. Aussprachefehler beeinträchtigen die Kommunikation, sie führen zur Unverständlichkeit von Namen, Wörtern und Äußerungen oder Mißverständnissen, sie bewirken Ermüdung und Konzentrationsverluste und beeinträchtigen die Sprachverarbeitung durch Assoziationen und Emotionen, die beim Hörer entstehen können.’’[1]
Diese vorliegende Forschung befasst sich mit der Wic
... Show MoreIn the article we consider features of official style, its functions and factors which influence the definition of the style. The topicality of the issue can be explained by rapid development of market economy which affects in its turn business correspondence. In this regard, there are a lot of cliché, terms and professionalisms appeared recently. Only correct usage of them can serve as a key to successful communication in Russian as well as other languages. This work highlights documents that are part of the diplomatic style such as declarations, credentials, notes, resolutions and other documents. The administrative style can include orders and instructions.
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... Show MoreThe study aimed to identify the degree of availability of design Thinking Indicators in The content of the Arabic Language Curricula at the secondary stage in the Syrian Arab Republic; to achieve the goal of the study. The researcher used the Descriptive Approach based on the analysis method according to the Cognitive Theory. The study tools consist of a list of Design Thinking Indicators and a Content Analysis Tool. The researcher completed the Validity and Reliability procedures for the tools. After applying them, the results of the study resulted in the following: Greater Interest than other sub-skills. The results also showed a Divergence of care for the sub-skills and the Difference in their recurrence rate, and the Omission of some
... Show MoreThis study aimed to explore The Degree of Practicing of the Sixth Primary Social Studies’ Teachers in Iraq for the Principles of Active Learning from their Point of view
The study society consisted of 230 male and femalesocial studiesteachers’ subjects for the sixth primary grade in Al-Anbar General Directorate of Education. 160 of them were selected to represent the sample of the study with a percent of (70%) from the original society. To achieve the aims of the study, the researchers prepared a questionnaire consisting of (43) items which represented the active learning principles. The validity and stability of the tool were verified. The researchers used the descriptive approach to suit the objectives of this study. &
... Show MoreThis research deals with the form of the physical identity which is concerned with the features and characteristics that distinguish the shape of the city from other existing cities and reveal its similarity with the self (itself) and objective difference with others. Accordingly, these features must be sophisticated and variable resulting the shape of the city, while preserving the continuity of time, and eventually leads to the emergence of the whole shape. Physical identity is conceptually equivalent with the terms "personality" and "sense of place". The research determined the criteria for evaluating the physical identity as follows:
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The entities responsible for regulating the financial market are seeking to provide high quality accounting information, to provide appropriate protection to investors, and thus encourage them and attract them to increase their investments. the research reached several conclusion, the most prominent of which comes :-
1-The production of high quality accounting information reduces investment costs and costs of processing accounting information.
2- The production of high quality accounting information helps investors identify the best investment opportunities.
3- The results of the statistical analysis showed that there is significant
... Show MoreAttitude is an important subject that has attracted researchers and thinkers in organizational theory and organizational behavior because of its great importance in various field studies. Field evidence suggests that individuals in their daily lives or careers respond to specific events through a set of internal tendencies Internal tendencies are negative or positive and systematic. These trends tend to be invisible, not limited to certain boundaries, and involve a significant number of individuals within organizations or society.
The research aims to identify the impact of trends in the ethics of public service workers for individuals, through a sample of (72) doctors and (60) administrative staff
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