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.
Abstract The means of self-determination have their peaceful and non-peaceful dimensions and are united(peaceful and non-peaceful) by international consensus adopted by international conventions and instruments. This has given it various dimensions at the applied level, especially in the light of the contemporary international developments witnessed by the world represented by a number of complete and incomplete implementation models that have nothing to do with the theory of truth Self-determination associated with the liberation of peoples from colonial domination or the liberation of oppressed nationalities
The research aims to diagnose the causes of the phenomenon of Marketing deception catalog, which is now deployed in the Iraqi market and related to producers and marketers, consumers, regulators and other institutions) and their impact in the areas of prejudice to the consumer protection (product and signifying specifications, price, advertising, packaging), as well as identify differences in the sample responses according to personal variables, it has been the adoption of the resolution as a tool to collect data and information through a sample survey of consumer opinions totaling 108 people in shopping centers in the province of Baghdad and in the Karkh and Rusafa, It was the use of methods selected statistical represented by the arith
... Show MoreThe study aimed to measure the phsycological tolerance and self-efficacy among the students of Baghdad university and knon the significant differences in psychological tolerance and self-efficacy according to the variables (Gender-Specialization)and the interaction between themas well as the study aimed to identify the strength and direction of the relationship between psychological tolerance and self-efficacy of the study sampleincluded asample of the current study(370) students from grades four ,the researcher used the measure of psychological tolerance and self-efficacy prepared by the researcher ,and the results showed that college students Generally have adegree of psychological tolerance and that there are statistically sig
... Show MoreWhat distinguishes human rights issues is their importance to the international community and their importance to democratic political regimes, because they are the axis of any political regime that seeks to achieve a successful democratic path and a stable state. So, countries that are interested in human rights try to enshrine those rights and freedoms in their constitutions and reinforce their concepts in their laws and legislations. Not to mention its involvement in international conventions and treaties concerned with human rights and freedoms, and this is what the Sultanate of Oman has worked on and confirm in the provisions of its 1996 constitution and its amendments
Objective(s): To assess the types of violence among adolescents in Baghdad City.
A descripƟve study which was using the assessment approach was conducted on purposive sample of 60 parents of
adolescent for identify types of adolescents violence in their families, was selected according to specific criteria for
participating in health education program towards adolescents' violence control in Baghdad city.
Methodology: A questionnaire was constructed for the purpose of the study. It was consisted of two parts; the first
part which included the parents' demographic characteristics for parents (sex, age, educational level and socioeconomic
status); the second part included types of adolescent violence that reported by par
The phenyl hydrazine was react readily with acetic acid chloride in [1:2] ratio in alkyl of ethanolic solution, and refluxe for five hours to produce a new ligand of (N-Carboxymethyl-N-phenyl-hydrazino)-acetic acid [H2L].
(1)
Christianity has rites and rituals that they should perform, and are indispensible. They say that these are sacred ordinances by Jesus Christ (PBUH) including the secret of priesthood. The origin of this secret as they claim is Christ. He puts the foundation of priesthood in Christianity. He has chosen twelve disciples and then seventeen whom he ordinated to obtain the honor of spreading the message of Christ among people. He appointed among the priests a divine message which the first fathers from the disciplesthemselves. The disciples are ones who take the secret and deliver it to the ones after them. The disciples took that sacred secret from Christ. Therefore, the secret is used when granting any religious position in the church. That s
... Show MoreThe purpose of this study is to assess the level of computer literacy of the students at AlQuds open university in Tulkarm Branch. The study investigates the effects of the variables of gender, specialization, academic level, owning a personal computer, internet communication, and own an email account on the level of computer literacy. A test of computer literacy was constructed by the researchers consisting of (37) multiple choice items with a reliability rate (0.85). The study population consisted of (4100) students, while the sample contained (352) students. The study revealed that the level of computer literacy of the students at AlQuds Open University in Tulkarm Branch was (66.2 %) which is educationally acceptable. It also
... Show MoreThe importance of earnings quality begin increase in recent year . Particulary after collapse the big companies in U.S.A When the Stock Prices of this Companies negative impact after reporting of transitory & unrealized earnings in the iterim reports , in the same time took to this earnings as absis of Future Predictions .
Many of acadmic researchers discusses empirical measures that used to assessments of earnings quality from the perspective of decision usefulness that represent core of FASB's conceptual Framework , and to the economic – based definition of earnings , developed by (Hicks) in 1939.
Tise research attempt to test som of earnings quality measures in commercial
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Scenes of love constitute a large space within the orbit of the movies, so that there is almost no film (no matter what kind) void of these scenes, as they are associated with many dimensions and they constitute a major attraction for viewers, and thus the direction solutions and their connection to the director's vision constitute a large part in the process of employing signs to highlight what should be highlighted or to refer to it symbolically on the grounds that the director does not have full freedom in the transfer of scenes of love at all levels as they are in reality. The research included three sections within the theoretical framework:The first section: the concept of image and its rhetorical importance. This section discussed
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